title: Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis.
abstract: Overhydration is reported to be the main cause of hypertension (HTN) as well as to have no association with HTN in hemodialysis (HD) population. This is the first report of the relationship between interdialytic weight gain (IDWG) and pre-HD blood pressure (BP) in pediatric patients in relation to residual urine output (RUO). We studied 170 HD sessions and interdialytic periods performed during a 12-week period in 5 patients [age 4-17 years, weight 20.8-66 kg, 3 anuric (102 HD sessions), and 2 nonanuric (68 HD sessions)]. BP is presented as systolic BP index (SBPI) and diastolic BP index (DBPI), calculated as systolic or diastolic BP/95th percentile for age, height, and gender. IDWG did not differ (P> 0.05) between anuric and nonanuric pts. There was a positive but not significant correlation between IDWG and both pre-HD SBPI (r= 0.833,P= 0.080) and pre-HD DBPI (r= 0.841,P= 0.074). Pre-HD SBPI (1.01 ± 0.12 versus 1.13 ± 0.18) and DBPI (0.92 ± 0.16 versus 1.01 ± 0.24) were higher in nonanuric patents (P< 0.001 andP< 0.01, resp.). Pre-HD HTN may not be solely related to IDWG and therapies beyond fluid removal may be needed. Individualized approach to HTN management is necessary in pediatric dialysis population.
authors.affiliation: Pediatric Nephrology, Yale University, New Haven, CT, USA.
authors.forename: Olivera
authors.identifier: 0000-0001-6626-8382
authors.initials: O
authors.lastname: Marsenic
authors.affiliation: Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Anderson
authors.affiliation: Pediatric Critical Care, Yale University, New Haven, CT, USA.
authors.forename: Kevin G
authors.identifier: 0000-0003-1998-7645
authors.initials: KG
authors.lastname: Couloures
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy* / Q000652:urine; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014563:Urodynamics; D015430:Weight Gain