| Popis: |
The impact of hypertension on renal and patients’ survival was retrospectively determined in children with chronic kidney disease (CKD). Seventy-seven of 154 CKD patients were hypertensive with 23 (30%) and 54 (70.0%) having stages I (123.0 ± 12.5/ 82.4 ± 10.6 mmHg) and II hypertension (161.0 ± 32.3/111.0 ± 23.0 mmHg), respectively. Seventy percent received two or more anti-hypertensive medications to achieve satisfactory blood pressure (BP) control. BP control was good, fair and poor in 43 (56.0%), 18 (23.4%), and 16 (20.6%) patients, respectively. Post-treatment BP in hypertensive CKD (hCKD) with good control was similar to normotensive CKD (nCKD), p=0.541. One/5 years renal survivals in nCKD (97.0/80.0%) were similar to hCKD with good BP control (96.2/63.0%, Log-rank p=0.362). nCKD, however, demonstrated significantly better one/five years renal survival (97.0/80.0%) than hCKD with fair (75.0/25.0%, p=0.014) and poor BP control (50.0/0.00%, p=0.003). hCKD with good BP control survived (66.7%) significantly better than hCKD with either fair (24.1%; p=0.002) or poor (0.0%; p=0.000) control. nCKD (90.4%) and hCKD with good BP control (66.7%) survived similarly, p=0.198. Cumulative mortality was significantly higher in hCKD (62.4%) than in nCKD (9.5%) [Hazard ratio: 0.54, 95% CI: 0.35-0.83, p=0.005]. Stage II occurred more frequently than stage I hypertension. Hypertension is a significant risk factor for poor renal survival and mortality in childhood CKD. Renal and patients’ survival was significantly better in hCKDs with post-treatment BP level ≤ 50th percentile compared to hCKDs with post-treatment BP level >50th percentile for age, gender, and height. |
