Keshri Swasti, Sharma Shobha, Agrawal Neha, Bansal Sandeep, Guilliani B P, Aggrawal Kailash Chandra
Department of Pediatrics, VMMC and Safdarjung Hospital, Delhi, New Delhi, 110029, India.
, 1228, Type IV (Special), R K Puram sec-12, Delhi, New Delhi, 110022, India.
Clin Exp Nephrol. 2018 Oct;22(5):1157-1162. doi: 10.1007/s10157-018-1565-3. Epub 2018 Mar 22.
Hypertension is not a typical feature of steroid sensitive nephrotic syndrome (SSNS) and the presence of persistent hypertension is suggestive of significant renal lesion. There is paucity of data regarding occurrence and severity of hypertension in SSNS in pediatric population during remission and was the main objective of this study. In addition, correlation with factors like family history, BMI, and lipid profile was studied.
Cross-sectional study conducted at tertiary care center in India including 81 children of infrequent relapsing SSNS between 1 and 10 years in remission and was off steroids. Grading and severity of hypertension were assessed. Statistical analysis was done using SPSS version 21.0.
Median age of presentation was 5 years, with male:female ratio of 1.3:1. Out of 81 infrequent relapsing SSNS children, 23.45% (19) had hypertension. Among those children with hypertension (n = 19), 73.68% (14) had positive family history compared to 32.25% (20) in those without hypertension. Positive correlation was found between BP and serum cholesterol and LDL. Of the hypertensive patients, 1 (5.26%) had fundus changes, 2 (10.52%) had features of left ventricular hypertrophy, and 13 (68.42%) had non-nephrotic range proteinuria.
There is high incidence of hypertension in NS children during remission. Though significant positive correlation was found with positive family history of hypertension and deranged lipid profile highlighting possibility of essential hypertension in them, there is need for close active monitoring and management of hypertension in them as untreated cases may have significant target organ damage.
高血压并非类固醇敏感性肾病综合征（SSNS）的典型特征，持续性高血压的存在提示有明显的肾脏病变。关于小儿SSNS缓解期高血压的发生率和严重程度的数据较少，这是本研究的主要目的。此外，还研究了其与家族史、体重指数（BMI）和血脂谱等因素的相关性。
在印度的一家三级医疗中心进行了一项横断面研究，纳入了81例年龄在1至10岁之间处于缓解期且已停用类固醇的罕复发SSNS患儿。评估高血压的分级和严重程度。使用SPSS 21.0版进行统计分析。
就诊时的中位年龄为5岁，男女比例为1.3:1。在81例罕复发SSNS患儿中，23.45%（19例）患有高血压。在这些高血压患儿中（n = 19），73.68%（14例）有家族史阳性，而无高血压患儿中这一比例为32.25%（20例）。发现血压与血清胆固醇和低密度脂蛋白之间存在正相关。在高血压患者中，1例（5.26%）有眼底改变，2例（10.52%）有左心室肥厚特征，13例（68.42%）有非肾病范围蛋白尿。
NS患儿缓解期高血压的发生率较高。虽然发现高血压家族史阳性和血脂异常与高血压有显著正相关，提示可能存在原发性高血压，但仍需要对他们进行密切的积极监测和管理，因为未经治疗的病例可能会有明显的靶器官损害。
