title: Effect of hypertension and antihypertensive medications on residual renal function in children treated with chronic peritoneal dialysis.
abstract: OBJECTIVE
  To evaluate the effect of hypertension (HTN) and antihypertensive medications (AHM) on residual renal function (RRF) in children on CAPD and APD.
  
  
  METHODS
  We retrospectively evaluated underlying kidney disease, systolic and diastolic blood pressure (SBP/DBP), presence and control of HTN (SBP/DBP≥95th percentile), AHM, RRF (daily diuresis, residual glomerular filtration rate [rGFR]), biochemical parameters, BMI Z-score, and dialysis parameters during 12-month follow-up in 87 children (38 CAPD, 49 APD) aged 10.22±4.31 years. The rate of RRF loss was expressed as absolute and relative [%] reduction.
  
  
  RESULTS
  At baseline, HTN was found in 74.7% patients (CAPD/APD: 84.2%/67.3%, P=0.06), most commonly in HUS and least frequently in CAKUT. The proportion of CAPD/APD patients with poorly controlled HTN was 70.0%/63.3% (P=0.50). Relative daily diuresis loss in children with uncontrolled HTN was higher (P=0.017) compared to children with SBP/DBP <95th percentile. No effect of AHM on the rate of RRF loss was found. In multivariate analysis, absolute daily diuresis loss was related to baseline diuresis (β=-0.30, P<0.001) and proteinuria (β=-0.31, P=0.004); absolute rGFR loss to baseline rGFR (β=-0.73, P<0.001) and glucose load after 12 months (β=-0.36, P=0.02); relative daily diuresis loss to mean BMI Z-score (β=-0.44, P=0.04); and relative rGFR to baseline rGFR (β=-0.37, P<0.001) and SBP percentile (β=-0.21, P=0.045).
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland. Electronic address: pskrzyp@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Skrzypczyk
authors.affiliation: Nephrology Division, Department of Pediatrics and Immunology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Jander
authors.affiliation: Nephrology Division, Department of Pediatrics and Immunology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Tkaczyk
authors.affiliation: Department of Pediatric and Adolescent Nephrology and Hypertension, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Irena
authors.initials: I
authors.lastname: Bałasz-Chmielewska
authors.affiliation: Department of Pediatric and Adolescent Nephrology and Hypertension, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Żurowska
authors.affiliation: Dialysis Unit, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Drożdż
authors.affiliation: Dialysis Unit, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Pietrzyk
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D011507:Proteinuria / Q000503:physiopathology; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: Arterial hypertension; Children; Peritoneal dialysis; Residual renal function