Seeman T, Sikut M, Konrad M, Vondrichová H, Janda J, Schärer K
1st Pediatric Clinic, University Hospital Motol, Prague, Czech Republic.
Pediatr Nephrol. 1997 Oct;11(5):592-6. doi: 10.1007/s004670050343.
The purpose of this study was to identify hypertension in children and adolescents in an early stage of autosomal dominant polycystic kidney disease (ADPKD) by the application of ambulatory blood pressure monitoring (ABPM) over 24 h; 32 children and adolescents (mean age 12.3 +/- 4.7 years) were examined. The diagnosis was based on family history and ultrasound examination. In 21 children ADPKD was confirmed by molecular genetic analysis. At the time of the study, 45% patients were asymptomatic and all had glomerular filtration rates (GFRs) > or = 65 ml/min per 1.73 m2. By ABPM, 11 patients (34%) were defined as hypertensive (systolic or diastolic blood pressure > 95th percentile), including 4 with an exclusive nocturnal hypertension. Of 7 patients with daytime hypertension, 4 had normal blood pressure by casual measurements. The nocturnal dip in blood pressure was reduced in 2 patients. Blood pressure correlated with renal size, but not with GFR, concentrating capacity, proteinuria, and plasma renin activity. The study reveals an early trend for increased blood pressure in children with ADPKD, requiring close supervision.
本研究的目的是通过应用24小时动态血压监测（ABPM）来早期识别常染色体显性多囊肾病（ADPKD）儿童及青少年中的高血压；对32名儿童及青少年（平均年龄12.3±4.7岁）进行了检查。诊断基于家族史和超声检查。21名儿童的ADPKD通过分子遗传学分析得以确诊。在研究时，45%的患者无症状，且所有患者的肾小球滤过率（GFR）≥65 ml/（min·1.73 m²）。通过ABPM，11名患者（34%）被定义为高血压（收缩压或舒张压＞第95百分位数），其中4名仅为夜间高血压。在7名白天高血压患者中，4名经偶测血压显示血压正常。2名患者的夜间血压下降幅度减小。血压与肾脏大小相关，但与GFR、浓缩功能、蛋白尿及血浆肾素活性无关。该研究揭示了ADPKD儿童中血压升高的早期趋势，需要密切监测。
