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慢性肾脏病患儿隐匿性高血压的患病率:一项横断面研究。

Prevalence of masked hypertension in children with chronic kidney disease: a cross-sectional study.

作者信息

Ak Nasmin, Satapathy Amit Kumar, John Joseph, Pati Akash Bihari, Kar Manisha, Sahu Suchanda

机构信息

Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.

Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.

出版信息

Pediatr Nephrol. 2025 Mar;40(3):811-818. doi: 10.1007/s00467-024-06563-7. Epub 2024 Nov 1.

Abstract

BACKGROUND

Hypertension poses a significant risk as a complication of chronic kidney disease (CKD), contributing to its hastened advancement. Implementing ambulatory blood pressure monitoring (ABPM), a straightforward and non-invasive method proves beneficial in identifying masked hypertension.

METHODS

A cross-sectional study was carried out involving children aged 5-15 years diagnosed with CKD to estimate the difference in masked HTN prevalence between the 2014 and 2022 AHA ABPM guidelines. The study encompassed a comprehensive assessment, including 24-h blood pressure monitoring and was performed using ABPM. Left ventricular mass (LVM) was computed based on measurements obtained from M-mode echocardiography. PWV was determined by calculating the ratio of distance (D) to time (t).

RESULTS

We examined a cohort of 138 children diagnosed with CKD. Our findings reveal that, in accordance with the 2022 American Heart Association (AHA) ABPM guidelines, prevalence of masked hypertension stands at 29.7% marking a notable increase of 17.4% compared to the 2014 ABPM guidelines signifying a substantial proportion of undetected hypertensive cases. Furthermore, the prevalence of hypertension is 48.5% as detected by ABPM, marking a notable increase of 22.5%.

CONCLUSIONS

A substantial occurrence of masked hypertension was identified in pediatric CKD patients through the application of ABPM. ABPM proves to be an effective tool for uncovering masked hypertension in children with CKD.

摘要

背景

高血压作为慢性肾脏病(CKD)的一种并发症,构成了重大风险,会加速其进展。实施动态血压监测(ABPM),这一简单且无创的方法,已被证明有助于识别隐匿性高血压。

方法

开展了一项横断面研究,纳入5至15岁被诊断为CKD的儿童,以评估2014年和2022年美国心脏协会(AHA)ABPM指南之间隐匿性高血压患病率的差异。该研究包括全面评估,其中有24小时血压监测,并使用ABPM进行。左心室质量(LVM)根据M型超声心动图测量值计算得出。脉搏波速度(PWV)通过计算距离(D)与时间(t)的比值来确定。

结果

我们检查了一组138名被诊断为CKD的儿童。我们的研究结果显示,根据2022年美国心脏协会(AHA)ABPM指南,隐匿性高血压患病率为29.7%,与2014年ABPM指南相比显著增加了17.4%,这表明有相当比例的高血压病例未被检测到。此外,通过ABPM检测到的高血压患病率为48.5%,显著增加了22.5%。

结论

通过应用ABPM,在儿科CKD患者中发现了大量隐匿性高血压病例。ABPM被证明是发现CKD儿童隐匿性高血压的有效工具。

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