Clinical analysis of changes of ambulatory blood pressure in children with primary nephrotic syndrome

Abstract

Objective: To explore the characteristics of the changes of ambulatory blood pressure (ABP) in the children with primary nephrotic syndrome (PNS). Methods: A total of 106 PNS children′s reports of 24-hour ambulatory blood pressure in Shanghai Children′s Medical Center were analyzed retrospectively. Results: The incidence of hypertension in PNS children was 60.4% (64/106), and 58.5% (62/106) children had nighttime hypertension, and 16.0% (17/106） children had daytime hypertension. The incidence of hypertension at night was higher than that in daytime(P<0.05). The loads of systolic blood pressure (SBP) and diastolic blood pressure (DBP) at night were higher than those at the daytime (SBP 52.32%±36.87% vs 19.41%±19.70%, DBP 39.22%±34.69% vs 18.42%±21.66%, P<0.05). Among 106 children, 92(86.8%) had abnormal circadian rhythms in SBP and/or DBP ambulatory blood pressure, and most of them were non-dippers (68.9%). SBP rhythm was more likely to be abnormal than DBP rhythm (79.2% vs 65.1%, P=0.022). There was a statistical difference in the rate of blood pressure decline between SBP and DBP at night [SBP (3.52%±6.97%) vs DBP (7.78%±9.18%), P<0.001]. The incidence of white-coat hypertension was 12.3%, and the incidence of masked hypertension was 14.2%. Conclusions: PNS children are prone to nocturnal hypertension and abnormal circadian rhythm, especially SBP. 24 h ambulatory blood pressure is conducive to collecting blood pressure change information and to guide the rational use of antihypertensive drugs for PNS children.

Keywords

• |ambulatory blood pressure|pediatric|primary nephrotic syndrome