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Ambulatory blood pressure monitoring in paediatric patients treated by regular haemodialysis and peritoneal dialysis

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Abstract

Ambulatory blood pressure monitoring (ABPM) has been shown to be more representive of blood pressure (BP) levels than casual BP measurements in adult patients treated by haemodialysis (HD). In this study we compared ABPM using the oscillometric SpaceLabs 90207 monitor with casual BP measurements in 35 paediatric patients [17 treated by peritoneal dialysis (PD) and 18 by DH]. Heart rate and plasma concentrations of atrial natriuretic peptide were also measured. No correlations were found between ABPM and casual BP measurements, except for systolic day-time BP in PD patients (r=0.63). Seventy percent of PD and 33% of HD patients were regarded as hypertensive when evaluated by ABPM, while casual BP measurements demonstrated hypertension in 47% (P<0.05) of PD patients and in 44% (NS) of HD patients. One-third of patients were reclassified by ABPM either from normotensive to hypertensive (7/19) or from hypertensive to normotensive (5/16). BP assessed by ABPM was higher in PD than in HD patients. The physiological decline of BP at night was significant and more prouounced in PD than in HD patients. In HD patients day-time BP did not differ between the 1st and the 2nd interdialytic day, but increased in the night hours before the following dialysis session. A positive correlation was found between day-time BP and pre-dialysis plasma atrial natriuretic peptide in both treatment groups. In conclusion this study demonstrates that casual BP recordings are not representative of average BP in dialysed paediatric patients. ABPM is useful in the diagnosis and treatment of hypertension in children with endstage renal disease.

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Authors and Affiliations

  1. Division of Paediatric Nephrology, University Children's Hospital, D-69120, Heidelberg, Germany

    Nicolaus Lingens, Marianne Soergel, Christopher Busch & Karl Schärer

  2. Division of Paediatric Nephrology, Hôpital Robert Debré, F-75019, Paris, France

    Marianne Soergel & Chantal Loirat

  3. Centre of Pharmacology, University of Frankfurt, D-60590, Frankfurt, Germany

    Björn Lemmer

Authors
  1. Nicolaus Lingens
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  2. Marianne Soergel
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  3. Chantal Loirat
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  4. Christopher Busch
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  5. Björn Lemmer
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  6. Karl Schärer
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Lingens, N., Soergel, M., Loirat, C. et al. Ambulatory blood pressure monitoring in paediatric patients treated by regular haemodialysis and peritoneal dialysis. Pediatr Nephrol 9, 167–172 (1995). https://doi.org/10.1007/BF00860734

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  • DOI: https://doi.org/10.1007/BF00860734

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