Abstract: FR-PO548

Association of Creatinine Levels and Hypertension in an International Cross-Sectional Database of Pediatric Patients on Chronic Hemodialysis: The PICCOLO MONDO Initiative

Session Information

Category: Hypertension

  • 1106 Hypertension: Clinical and Translational - Secondary Causes


  • Topping, Alice, Renal Research Institute, New York, New York, United States
  • Guerrero kanan, Ricardo, Instituto Nacional de Perinatologia, Mexico, Mexico
  • Alvarez-Elias, Ana Catalina, MEXICO CHILDRENS HOSPITAL. FEDERICO GOMEZ, Tlalnepantla de Baz, Mexico
  • Medeiros, Mara, Hospital Infantil de México Federico Gómez, MEXICO, D.F., DISTRITO FEDERAL, Mexico
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Ferris, Maria E., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Hypertension is a concern when treating pediatric chronic hemodialysis (cHD) patients due its association with cardiovascular morbidity and mortality. We aim to describe the association of laboratory markers and demographic information with hypertension in pediatric cHD patients from the PICCOLO MONDO Initiative.


Routine treatment and laboratory information was compiled in the PICCOLO MONDO database from the years 2000 to 2010. Hypertension was classified as ≥ 95th percentile of pre-treatment systolic sitting blood pressure (SBP) based on age-, sex-, and height-specific percentiles. For subgroup analysis, patients were divided into 4 regions: Asia Pacific (AP), Europe (EU), Latin American (LA) and North America (NA) and 4 age groups: 0-5, 6-12, 13-15, 16-18 y.o.a. The study was approved by the University of North Carolina IRB.


Data from 439 cHD patients < 18 y.o.a in 21 countries were analyzed. The median age was 16 y.o.a. (IQR 13 to 17) and 52.9% were male. Overall, 16.4% of patients were classified as hypertensive. This proportion varied by region: 31.9% of patients in NA , 26.5% in EU, 15.9% in AP and 12.4% of patients in LA were hypertensive (p=0.002). Creatinine was significantly higher in hypertensive patients (8.9±3.3 v. 7.7±3 p=0.02). Creatinine levels varied by age group and region (p=0.04 for regional and p=0.002 for age group comparisons). Logistic regression analysis shows that when controlling for region and age group, each one mg/dL increase in creatinine was associated with a 1.18 times increase in risk of having hypertension (95% CI 1.05 to 1.22).


We found differences in hypertension prevalence by region. Elevated creatinine was found to be a risk factor for hypertension, which may indicate that residual renal function protects against hypertension in pediatric cHD patients.


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