ESPN 54th Annual Meeting

ESPN 2022


 
AMBULATORY BLOOD PRESSURE CORRELATES WITH MRI-BASED RENAL VOLUME IN CHILDREN AND ADOLESCENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE
Kubra Yilmaz 1 Seha Saygili 2 Ozlem Akgun-Dogan 3 Zeynep Nagehan Yuruk Yildirim 4 Rumeysa Yasemin Cicek 5 Huseyin Adil Oner 4 Bagdagul Aksu 6 Nazli Gulsum Akyel 7 Ozge Oguzhan 1 Hasan Dursun 8 Sevgi Yavuz 9 Neslihan Cicek 10 Nurver Akinci 11 Ayse Agbas 2 Ahmet Nevzat Nayir 4 Dildar Konukoglu 12 Sebuh Kurugoglu 7 Lale Sever 2 Nur Canpolat 2 Salim Caliskan 2

1- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey
2- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
3- Ac─▒badem University School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Istanbul, Turkey
4- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
5- Istanbul Basaksehir Cam and Sakura City Hospital, Department of Pediatric Nephrology, Istanbul, Turkey
6- Istanbul University, Institute of Child Health, Department of Pediatric Basic Sciences, Istanbul, Turkey
7- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Radiology, Istanbul, Turkey
8- Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Department of Pediatric Nephrology, Istanbul, Turkey
9- University of Health Sciences, Istanbul Basaksehir Cam and Sakura City Hospital, Department of Pediatric Nephrology, Istanbul, Turkey
10- Marmara University School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
11- Koc University Hospital, Department of Pediatric Nephrology, Istanbul, Turkey
12- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey
 
Introduction:

Hypertension (HT) is a major risk factor for cardiovascular disease in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). The aim of this study is to determine the frequency of HT in children with ADPKD and reveal the relationship between MRI-based kidney volumes, blood pressures (BP) and kidney functions. 

Material and methods:

This cross-sectional, single-center study included 89 patients (39 girls, 50 boys) diagnosed with ADPKD, and age- and sex-matched 27 healthy children (13 girls, 14 boys) as controls. BP was determined by both office measurements and 24-hour ambulatory BP measurements. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine and cystatin C levels using the CKiD equation. The MRI-based total kidney volumes (TKV) of the patients were measured with the manual planimetry method, and corrected by the patient’s height. 

Results:

The median age of patients was 6.9 years, with a median follow-up of 5.2 years. 79 children had a genetically proven diagnosis, whereas 10 children were diagnosed with clinical characteristic. Mean eGFR of the children with ADPKD (112 ml/min/1.73m2) was significantly lower than the control group. None of the patients had an eGFR <90 ml/min/1.73m2. The corrected TKV of the patient group was significantly bigger than the control group. ABPM revealed ambulatory HT in 23%, masked HT in 2%, and white coat HT in 13%. 17% of the patients were using antihypertensive treatment during the evaluation. Totally, 41% of the patients were diagnosed with HT. A high 24-h MAP-SDS was independently associated only with higher levels of TKV [95%CI: 0.002-0.006; p<0.001]. 

Conclusions:

This study revealed a significant relationship between MRI-based kidney volume and blood pressure values measured with ABPM. 24-h ABPM should be used for the evaluation of HT especially in patients with increased renal size.