title: Ambulatory blood pressure monitoring is recommended in the clinical management of children with a solitary functioning kidney.
abstract: BACKGROUND
  Children with a solitary functioning kidney are at increased risk of developing chronic kidney disease. Hypertension may be an early indicator of renal dysfunction in these patients. We determined blood pressure (BP) profiles of children with a solitary functioning kidney by using ambulatory BP monitoring (ABPM).
  
  
  METHODS
  To assess the occurrence with (pre)hypertension, we compared ABPM to office BP measurement in 47 children with a solitary functioning kidney. None of the subjects used antihypertensive agents or had been hypertensive during previous clinical visits.
  
  
  RESULTS
  Mean age of study subjects was 12.7 (±3.3) years. Hypertension was identified in ten (21 %) subjects with ABPM, whereas only two (4 %) children were hypertensive during office BP measurement (p < 0.01). Fifteen (32 %) children had an ABPM standard deviation (SD) value ≥90th percentile versus six (13 %) subjects based on office BP measurement (p = 0.051). Although 24-h ABPM SD scores were higher in the congenital type than in the acquired type of solitary functioning kidney (p ≤ 0.01), the proportions of subjects with 24-h ABPM hypertension were similar between groups (congenital 25 % versus acquired 16 %; p = NS).
  
  
  CONCLUSIONS
  Based on ABPM, one in five children with a solitary functioning kidney has hypertension. As the majority of these subjects were not hypertensive during office BP measurements, ABPM should be considered in the clinical management of solitary functioning kidney patients.
authors.affiliation: Department of Pediatric Nephrology, VU University Medical Center, PO Box 7057, 1007MB, Amsterdam, The Netherlands, r.westland@vumc.nl.
authors.forename: Rik
authors.initials: R
authors.lastname: Westland
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Schreuder
authors.forename: David F
authors.initials: DF
authors.lastname: van der Lof
authors.forename: Annemieke
authors.initials: A
authors.lastname: Vermeulen
authors.forename: Inge M J
authors.initials: IM
authors.lastname: Dekker-van der Meer
authors.forename: Arend
authors.initials: A
authors.lastname: Bökenkamp
authors.forename: Joanna A E
authors.initials: JA
authors.lastname: van Wijk
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007674:Kidney Diseases / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D058246:Prehypertension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D003404:Creatinine