Resolved Childhood Glomerular Disease Linked to HTN Risk
Findings show increased risk of subsequent hypertension over 18 years of follow-up
THURSDAY, March 20, 2014 (HealthDay News) -- Resolved childhood glomerular disease is associated with increased subsequent risk of hypertension, according to a research letter published in the March 19 issue of the Journal of the American Medical Association.
Asaf Vivante, M.D., from the Sheba Medical Center in Tel Hashomer, Israel, and colleagues examined whether a medical history of resolved childhood glomerular disease confers a future risk for hypertension. Participants (38,144 male career Israel Defense Forces personnel) were followed from the time of medical assessment during adolescence (1970 to 1997) through the Staff Periodic Examination Center visits (1994 to 2010) until diagnosis of hypertension or retirement from service.
The researchers found that 264 participants were diagnosed with a medical history of resolved childhood glomerular disease. During a mean follow-up of 18 years, hypertension developed among 2,856 participants, including 13.6 percent of those with and 7.4 percent of those without a medical history of resolved childhood glomerular disease (crude hazard ratio, 1.63 [95 percent confidence interval, 1.17 to 2.26]; age- and body mass index-adjusted hazard ratio, 1.67 [95 percent confidence interval, 1.20 to 2.31]). Based on creatinine values, available for 76 percent of the cohort, 2.0 percent of those with and 1.1 percent of those without a medical history of resolved childhood glomerular disease had an estimated glomerular filtration rate below 60 mL/min/1.73 m², for an age-adjusted hazard ratio of 1.53 (95 percent confidence interval, 0.57 to 4.10).
"Glomerular disease during childhood may represent a continuum of kidney injury that begins well before sufficient loss of excretory kidney function can be measured with standard laboratory tests, such that the first manifestation may be adult hypertension," the authors write.
One author disclosed financial ties to Elsevier, and one author received reimbursement from COST.