Kidney Week

Abstract: SA-PO0667

Ambulatory Blood Pressure Monitoring Thresholds for Predicting Left Ventricular Hypertrophy in Children Aged 6-12 Years: Pediatric Nephrology Research Consortium Study

Session Information

• Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Jahan, Afsana, Northwell Health, New Hyde Park, New York, United States

Afsana Jahan, MBBS

• Schuchman, Matthew, Northwell Health, New Hyde Park, New York, United States

Matthew Schuchman

• Manchanda, Eshanika, Children's Mercy Kansas City, Kansas City, Missouri, United States

Eshanika Manchanda

• Lomanta, Francis Vincent, University of Utah Health, Salt Lake City, Utah, United States

Francis Vincent Lomanta, DO

• Kim, Hannah, Weill Cornell Medicine, San Francisco, California, United States

Hannah Kim, MD

• Mazo, Alexandra, Boston Children's Health Physicians, Valhalla, New York, United States

Alexandra Mazo, MD, PhD

• Samsonov, Dmitry V., Boston Children's Health Physicians, Valhalla, New York, United States

Dmitry V. Samsonov, MD

• Srivastava, Tarak, Children's Mercy Kansas City, Kansas City, Missouri, United States

Tarak Srivastava, MD, FASN

• Yamaguchi, Ikuyo, The University of Oklahoma Health Sciences Center - University Health Club, Oklahoma City, Oklahoma, United States

Ikuyo Yamaguchi, MD, PhD

• Sethna, Christine B., Northwell Health, New Hyde Park, New York, United States

Christine B. Sethna, MD, MEd

Group or Team Name

• Pediatric Nephrology Research Consortium.

Background

Ambulatory blood pressure monitoring (ABPM) is recommended to confirm hypertension in children. While adult thresholds are used in adolescents ≥13 years, evidence-based ABPM thresholds predictive of cardiovascular (CV) outcomes in younger children require investigation.

Methods

This ongoing multicenter, retrospective study included children aged 6–12 years who had ABPM and echocardiography within 3 months between January 2015 and July 2024. Inclusion required ABPM reports with ≥40 valid and ≥65% successful ABPM reading. Children with heart disease or taking antihypertensives >1 month prior to ABPM were excluded. Current 95th %ile thresholds (2022 AAP) and proposed systolic thresholds (wake: 120, 115, 110 mmHg; sleep: 110, 105, 100 mmHg; 24-hr: 115, 110, 105 mmHg) and diastolic thresholds (70, 65 mmHg) were tested. Outcomes included left ventricular mass index (LVMI) and LVH (defined as LVMI ≥51 g/m^2.7 or ≥95th %ile for age and sex). Discrimination was assessed using area under the receiver operating characteristic curve, sensitivity, specificity, and Youden’s Index.

Results

Of 114 children (50% male; median age 10 years [IQR 8.6–11.4]), LVH present in 5 and 29 children (≥51 g/m².⁷ or >95th percentile). Across wake, sleep, and 24-hr intervals, both current 95%ile and proposed BP thresholds showed poor discriminatory ability for LVH. All thresholds had low AUCs (≤0.534) and Youden’s indices (≤0.24).

Conclusion

Fixed BP cutoffs were not significantly better predictors of LVH compared to current 95%ile. These findings highlight the need for improved pediatric ABPM thresholds that better predict CV target organ damage.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025m417w9d1