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Pediatric Nephrology
Published in: Pediatric Nephrology 10/2019

Open Access 01-10-2019 | Polycystic Kidney Disease | Original Article

Central blood pressure and measures of early vascular disease in children with ADPKD

Authors: Matko Marlais, Sreedevi Rajalingam, Haotian Gu, Alexandra Savis, Manish D Sinha, Paul JD Winyard

Published in: Pediatric Nephrology | Issue 10/2019

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Abstract

Background

There is growing recognition of hypertension in a significant proportion of children with ADPKD. In this study, we assessed blood pressure and cardiovascular status in children with ADPKD.

Methods

A prospective two-centre observational study of children (< 18 years) with ADPKD was compared against age- and BMI-matched healthy controls. Children underwent peripheral BP (pBP) measured using an aneroid sphygmomanometer and auscultation, 24-h ambulatory BP monitoring (ABPM), non-invasive central BP (cBP) measurement, carotid-femoral pulse wave velocity (PWVcf) measured using applanation tonometry and measurement of indexed left ventricular mass (LVMI) using echocardiography. This study received independent ethical approval.

Results

Forty-seven children with ADPKD and 49 healthy controls were recruited (median age 11 years vs. 12 years). Children with ADPKD had significantly higher systolic pBP (mean 112 ± 13.5 mmHg vs. 104 ± 11 mmHg, p < 0.001), higher systolic cBP (mean 97 ± 12.8 mmHg vs. 87 ± 9.8 mmHg, p < 0.001) and lower pulse pressure amplification ratio (1.59 ± 0.2 vs. 1.67 ± 0.1, p = 0.04) compared to healthy children. Thirty-five percent of children with ADPKD showed a lack of appropriate nocturnal dipping on 24-h ABPM. There was no difference in PWVcf between children with ADPKD and healthy children (mean 5.74 ± 1 m/s vs. 5.57 ± 0.9 m/s, p = 0.46). Those with ADPKD had a significantly higher LVMI (mean 30.4 ± 6.6 g/m2.7 vs. 26.2 ± 6.2 g/m2.7, p = 0.01).

Conclusions

These data highlight the high prevalence of hypertension in children with ADPKD, also demonstrating early cardiovascular dysfunction with increased LVMI and reduced PP amplification despite preserved PWVcf, when compared with healthy peers. These early cardiovascular abnormalities are likely to be amenable to antihypertensive therapy, reinforcing the need for routine screening of children with ADPKD.
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Metadata
Title
Central blood pressure and measures of early vascular disease in children with ADPKD
Authors
Matko Marlais
Sreedevi Rajalingam
Haotian Gu
Alexandra Savis
Manish D Sinha
Paul JD Winyard
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 10/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04287-7

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