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Observational Study
. 2024 Jul;39(7):2161-2170.
doi: 10.1007/s00467-024-06301-z. Epub 2024 Feb 6.

Longitudinal analysis of blood pressure and lipids in childhood nephrotic syndrome

Johnathon Carboni  1 , Elizabeth Thomas  2 , Debbie S Gipson  3 , Tammy M Brady  4 , Tarak Srivastava  5 , David T Selewski  6 , Larry A Greenbaum  7 , Chia-Shi Wang  7 , Katherine M Dell  8 , Frederick Kaskel  9 , Susan Massengill  10 , Kimberly Reidy  9 , Cheryl L Tran  11 , Howard Trachtman  3 , Richard Lafayette  12 , Salem Almaani  13 , Sangeeta Hingorani  14 , Rasheed Gbadegesin  15 , Keisha L Gibson  16 , Christine B Sethna  17 ; Nephrotic Syndrome Study Network (NEPTUNE)*
Collaborators, Affiliations
Observational Study

Longitudinal analysis of blood pressure and lipids in childhood nephrotic syndrome

Johnathon Carboni et al. Pediatr Nephrol. 2024 Jul.

Abstract

Background: In the current study, longitudinal BP and lipid measurements were examined in a NEPTUNE cohort of children with newly diagnosed nephrotic syndrome (cNEPTUNE). We hypothesized that hypertensive BP and dyslipidemia would persist in children with nephrotic syndrome, regardless of steroid treatment response.

Methods: A multi-center longitudinal observational analysis of data obtained from children < 19 years of age with new onset nephrotic syndrome enrolled in the Nephrotic Syndrome Study Network (cNEPTUNE) was conducted. BP and lipid data were examined over time stratified by disease activity and steroid exposure. Generalized estimating equation regressions were used to find determinants of hypertensive BP and dyslipidemia.

Results: Among 122 children, the prevalence of hypertensive BP at any visit ranged from 17.4% to 57.4%, while dyslipidemia prevalence ranged from 40.0% to 96.2% over a median of 30 months of follow-up. Hypertensive BP was found in 46.2% (116/251) of study visits during active disease compared with 31.0% (84/271) of visits while in remission. Dyslipidemia was present in 88.2% (120/136) of study visits during active disease and in 66.0% (101/153) while in remission. Neither dyslipidemia nor hypertensive BP were significantly different with/without medication exposure (steroids and/or CNI). In regression analysis, male sex and urine protein:creatinine ratio (UPC) were significant determinants of hypertensive BP over time, while eGFR was found to be a determinant of dyslipidemia over time.

Conclusions: Results demonstrate persistent hypertensive BPs and unfavorable lipid profiles in the cNEPTUNE cohort regardless of remission status or concurrent steroid or calcineurin inhibitor treatment.

Keywords: Children; Cholesterol; Hypertension; Nephrotic syndrome; Pediatric.

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Conflict of interest statement

Conflicts of Interest: C.S has been on an advisory board for Travere Therapeutics.

Figures

Figure 1.
Figure 1.
Prevalence of Hypertensive Blood Pressure and Dyslipidemia Over Time
Figure 2.
Figure 2.
Hypertensive Blood Pressure by Steroid Exposure and Disease Activity
Figure 3.
Figure 3.
Dyslipidemia by Steroid Exposure and Disease Activity
See this image and copyright information in PMC

References

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