Ambulatory Blood Pressure Monitoring in Children with Solitary Kidney

Abstract

Background: Children with a solitary kidney are at risk of developing hypertension due to decreased nephron number with a consequence of hyperfiltration of the remnant. In patients with high-risk conditions, ambulatory blood pressure monitoring (ABPM), which records blood pressure (BP) for 24 hours, is helpful in detecting hypertension. Objectives: To investigate the prevalence of hypertension in children with solitary kidney using 24-h ABPM and comparing with the office blood pressure (OBP). Methods: Twenty-three patients aged 5-18 years-old were enrolled. Demographic, anthropometric and biochemical data were collected. OBP measurement with sphygmomanometer was recorded at the out-patient clinic, and patients were given a 24-h ABPM automatically records BP every 20 minutes during the day and every 30 minutes at night. Results: Mean age of the subjects was 9.5 ± 3.9 years-old. Eleven patients (47.8%) were diagnosed with hypertension using 24-h ABPM, while only 6 patients (26.1%) were hypertensive using OBP measurement. Among 11 hypertensive patients in the ABPM group, 63.6% are considered to have masked hypertension. Subgroup analysis showed that obese had mean systolic BP load higher than non-obese, 48.1 ± 22.3% and 28.1 ± 17.3% respectively. in children with solitary kidney is seen more often if based on ABPM than on OBP measurement. Using 24-h ABPM in a high-risk group should be implemented in out-patient settings to early detect hypertension.