کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2032001 | 1071645 | 2015 | 7 صفحه PDF | دانلود رایگان |
PurposeTo evaluate the effect of hypertension (HTN) and antihypertensive medications (AHM) on residual renal function (RRF) in children on CAPD and APD.Material/methodsWe retrospectively evaluated underlying kidney disease, systolic and diastolic blood pressure (SBP/DBP), presence and control of HTN (SBP/DBP ≥ 95th percentile), AHM, RRF (daily diuresis, residual glomerular filtration rate [rGFR]), biochemical parameters, BMI Z-score, and dialysis parameters during 12-month follow-up in 87 children (38 CAPD, 49 APD) aged 10.22 ± 4.31 years. The rate of RRF loss was expressed as absolute and relative [%] reduction.ResultsAt baseline, HTN was found in 74.7% patients (CAPD/APD: 84.2%/67.3%, P = 0.06), most commonly in HUS and least frequently in CAKUT. The proportion of CAPD/APD patients with poorly controlled HTN was 70.0%/63.3% (P = 0.50). Relative daily diuresis loss in children with uncontrolled HTN was higher (P = 0.017) compared to children with SBP/DBP <95th percentile. No effect of AHM on the rate of RRF loss was found. In multivariate analysis, absolute daily diuresis loss was related to baseline diuresis (β = −0.30, P < 0.001) and proteinuria (β = −0.31, P = 0.004); absolute rGFR loss to baseline rGFR (β = −0.73, P < 0.001) and glucose load after 12 months (β = −0.36, P = 0.02); relative daily diuresis loss to mean BMI Z-score (β = −0.44, P = 0.04); and relative rGFR to baseline rGFR (β = −0.37, P < 0.001) and SBP percentile (β = −0.21, P = 0.045).Conclusions1.Maintaining blood pressure <95th percentile helps preserve RRF in children with ESRD treated with peritoneal dialysis.2.Risk factors for rapid RRF loss in children on CAPD/APD include elevated SBP, high baseline diuresis/rGFR, proteinuria, and high glucose load in the dialysis fluid.
Journal: Advances in Medical Sciences - Volume 60, Issue 1, March 2015, Pages 18–24