Kidney Week

Abstract: TH-PO496

Risk of Target Organ Damage in Pediatric CKD Patients with Ambulatory Hypertension: A Systematic Review and Meta-Analysis

Session Information

• Pediatric Nephrology - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Chung, Jason, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada

Jason Chung,

• Robinson, Cal, The Hospital for Sick Children, Toronto, Ontario, Canada

Cal Robinson,

• Yu, Andrew, University of Alberta, Edmonton, Alberta, Canada

Andrew Yu,

• Sheffield, Lauren, McMaster University, Hamilton, Ontario, Canada

Lauren Sheffield,

• Sinha, Manish, Evelina London Children's Hospital, London, London, United Kingdom

Manish Sinha,

• Dionne, Janis M., BC Children's Hospital, Vancouver, British Columbia, Canada

Janis M. Dionne,

• Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Mark Mitsnefes,

• South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States

Andrew M. South,

• Parekh, Rulan S., Women's College Hospital, Toronto, Ontario, Canada

Rulan S. Parekh,

• Rodrigues, Myanca D., McMaster University, Hamilton, Ontario, Canada

Myanca D. Rodrigues,

• Noone, Damien Gerard, The Hospital for Sick Children, Toronto, Ontario, Canada

Damien Gerard Noone,

• Chanchlani, Rahul, McMaster Children's Hospital, Hamilton, Ontario, Canada

Rahul Chanchlani,

Background

The objective of this systematic review is to determine the association between ambulatory hypertension and left ventricular mass index (LVMI) as well as ambulatory blood pressure monitoring (ABPM) parameters in youth with CKD.

Methods

A systematic literature search on 9 databases included English publications from 1974-2022. LVMI was indexed to subject height and body surface area (g/m^2.7). Correlation coefficients were transformed and pooled using a random effects model.

Results

Of 1,128 screened studies, 16 studies and 2,254 children and adolescents were included. LVMI was elevated in the hypertensive group compared to the normotensive group (mean difference: 6.22 g/m^2.7, 95% CI: 4.80-7.65). Hypertensive children were at 3.34 (95% CI: 2.38-4.68) increased odds of left ventricular hypertrophy compared to normotensive children. Estimates of pooled correlation coefficients demonstrated nighttime systolic (r=0.46, 95%CI: 0.36, 0.56) and daytime systolic (r=0.43, 95%CI: 0.33-0.53) BP to have the strongest positive linear relationship to LVMI.

Conclusion

Pediatric CKD patients with ambulatory hypertension especially during nighttime are at significant risk of increased LVMI. Adequate blood pressure control among children with CKD is imperative to avoid the risk of target organ damage and future cardiovascular disease.