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Hypertension Found Common in Pediatric Kidney Disease

Condition linked to high risk of left ventricular enlargement; monitoring is recommended

WEDNESDAY, Nov. 18 (HealthDay News) -- Children with chronic kidney disease often have high blood pressure, increasing their risk of left ventricular enlargement, according to a study published online Nov. 16 in the Journal of the American Society of Nephrology.

Mark Mitsnefes, M.D., from the Cincinnati Children's Hospital Medical Center, and colleagues investigated cardiovascular risk among 366 children with stages 2 to 4 chronic kidney disease who had baseline echocardiography, of which 198 had ambulatory and casual blood pressure assessment.

The researchers found that 17 percent of children had left ventricular hypertrophy, 9 percent had concentric remodeling of the left ventricle, 38 percent had masked hypertension (normal casual but elevated ambulatory blood pressure), and 18 percent had confirmed hypertension (elevated casual and ambulatory blood pressure). After adjusting for confounding factors, left ventricular hypertrophy was independently predicted by masked hypertension (odds ratio, 4.1) and confirmed hypertension (odds ratio, 4.3). No significant association was found between left ventricular hypertrophy and kidney function.

"The high prevalence of masked hypertension and its association with left ventricular hypertrophy supports early echocardiography and ambulatory blood pressure monitoring to evaluate cardiovascular risk in children with chronic kidney disease," Mitsnefes and colleagues conclude.

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