ESPN 54th Annual Meeting

ESPN 2022


 
Prevalence of left ventricular hypertrophy in children and young adults with chronic kidney disease and masked hypertension: a systematic review and meta-analysis
IOANNIS GOULAS 1 KLEO EVRIPIDOU 1 IOANNIS DOUNDOULAKIS 2 ATHANASIA CHAINOGLOU 1 THOMAI NIKA 1 STELLA STABOULI 1

1- 1ST DEPARTMENT OF PEDIATRICS, SCHOOL OF MEDICINE, FACULTY OF HEALTH SCIENCES, ARISTOTLE UNIVERSITY THESSALONIKI, HIPPOKRATIO HOSPITAL, THESSALONIKI, GREECE
2- DEPARTMENT OF CARDIOLOGY, 424 GENERAL MILITARY TRAINING HOSPITAL, THESSALONIKI, GREECE
 
Introduction:

 Undetected hypertension (HTN) in children with chronic kidney disease (CKD) may result in undertreatment of patients with subclinical TOD. In this meta-analysis we aimed to investigate the prevalence of left ventricular hypertrophy (LVH) in children and young adults with CKD and hypertensive ambulatory BP phenotypes, sustained and masked HTN.

Material and methods:

 We assessed studies that included children, adolescents, and young adults with CKD and reported data on echocardiography as well as BP levels by both office and ambulatory BP monitoring. Only studies using ambulatory BP monitoring were included, in order to prevent misclassification of BP status.

Results:

 The systematic literature search retrieved 1283 studies. We finally included 3 studies with a mean participants’ age 13.79 ± 4.35 years. Among three studies that reported data on the overall prevalence of LVH in  a total of 238 CKD patients with ambulatory hypertension, the prevalence of LVH was found 0.28 (95% CI, 0.19, 0.39) . In four studies (including the three studies mentioned) including 172 CKD patients with masked hypertension, LVH was detected in 49 patients, with the estimated prevalence being 0.23 (95%CI, 0.15, 0.32).

Conclusions:

 Our data emphasize the growing evidence on the important role of echocardiography and ambulatory BP monitoring to evaluate cardiovascular risk in children with CKD . Diagnosis of masked hypertension carries an adverse prognosis, with increased risk of LVH and associated future cardiovascular events.