Ambulatory blood pressure monitoring in children with vesicoureteral reflux

Abstract

Objective: To assess the value of ambulatory blood pressure monitoring (ABPM) for identifying the risk of hypertension (HT) in children with vesicoureteral reflux (VUR).

Methods: Seventy-six children with primary VUR were enrolled. Patients were divided into 2 groups according to renal scarring (RS). Serum creatinine, urine protein, and urine creatinine were measured. All patients underwent ABPM and casual blood pressure (BP) examination. ABPM measurements were standardized to age, gender, and height by Lambda-Mu-Sigma method.

Results: Urine protein and creatinine concentrations were statistically higher in RS (+) group than RS (-) group (P = .05). Casual systolic and diastolic BP standard deviation score (SDS) values were not statistically different between RS (+) and RS (-) groups. Day, night and 24-hour systolic BP SDS, day and 24-hour mean arterial blood pressure SDS values were significantly higher in RS (+) group than that of RS (-) group (P = .015, P = .031, P = .013, P = .07, and P = .021, respectively). All ABPM values significantly increased in patients with severe RS compared with ones with mild and moderate RS (P <.05). Casual and ambulatory BP SDS values did not significantly differ by grade of VUR (P >.05).

Conclusion: ABPM is more sensitive than casual BP measurements and might be used for early identification of HT in VUR patients. The severity of RS increases the risk of HT in children with VUR. Controlling HT with proteinuria would decrease the progression of renal damage in VUR.