Obrycki Łukasz, Skoczyński Krzysztof, Sikorski Maksymilian, Koziej Jan, Mitoraj Kacper, Pilip Jakub, Pac Michał, Feber Janusz, Litwin Mieczysław
Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04 - 730, Warsaw, Poland.
Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland.
Pediatr Nephrol. 2025 May 20. doi: 10.1007/s00467-025-06761-x.
While hypertension (HT) in pediatric patients is often secondary (SH), recent trends show a rise in primary hypertension (PH), which is associated with an increasing global prevalence of obesity. A relationship between serum uric acid and PH has also been suggested. Our study aimed to assess the etiology of HT and factors associated with PH in a large European cohort of children referred for HT based on office blood pressure (BP) measurements.
We performed a retrospective analysis of 2008 children aged 0-18 years (12.3 ± 4.9 years) diagnosed with HT. Patients were classified into white coat hypertension (WCH), PH, or SH groups based on office BP, 24-h ambulatory BP monitoring (ABPM) and clinical evaluation. Anthropometric, hemodynamic, and biochemical data were collected.
Out of 2008 patients included in the analysis, 200 (10%) were excluded due to multifactorial HT diagnosis after kidney transplantation (KTx). Among the remaining patients HT was confirmed in 1260 (548 were classified as WCH). Of 1260 patients with HT: 49.3% had PH, while 50.7% SH, mainly secondary to renal parenchymal disease (43.5% of SH patients), aortic coarctation (20.7%), and renovascular HT (18%). Age > 12.5 years, obesity (BMI SDS (standard deviation score) ≥ 1.65), and serum uric acid > 4.8 mg/dL were identified as significant factors associated with PH.
Our study provides valuable insights into the current etiology of pediatric HT and highlights the role of age, obesity, and uric acid level in the diagnosis of PH in children.
虽然儿科患者的高血压（HT）通常是继发性的（SH），但最近的趋势显示原发性高血压（PH）有所上升，这与全球肥胖患病率的增加有关。血清尿酸与PH之间的关系也已被提出。我们的研究旨在评估在一个基于诊室血压（BP）测量而转诊来的大型欧洲儿童队列中HT的病因及与PH相关的因素。
我们对2008名年龄在0至18岁（平均12.3±4.9岁）被诊断为HT的儿童进行了回顾性分析。根据诊室血压、24小时动态血压监测（ABPM）和临床评估，将患者分为白大衣高血压（WCH）、PH或SH组。收集了人体测量学、血流动力学和生化数据。
在纳入分析的2008名患者中，200名（10%）因肾移植（KTx）后多因素HT诊断而被排除。在其余患者中，1260名（548名被分类为WCH）确诊为HT。在1260名HT患者中：49.3%患有PH, 而50.7%为SH，主要继发于肾实质疾病（43.5%的SH患者）、主动脉缩窄（20.7%）和肾血管性HT（18%）。年龄>12.5岁、肥胖（BMI标准差评分（SDS）≥1.65）和血清尿酸>4.8mg/dL被确定为与PH相关的重要因素。
我们的研究为儿科HT的当前病因提供了有价值的见解，并强调了年龄、肥胖和尿酸水平在儿童PH诊断中的作用。
