SEATTLE—Many children receiving dialysis continue to have poor blood pressure control even when on antihypertensive treatment, a cross-sectional study found.
Six months after beginning dialysis, 67.9 percent of pediatric patients with end-stage renal disease (ESRD) had hypertension that was either uncontrolled or untreated, according to Susan M. Halbach, MD, of Seattle Children's Hospital, and colleagues.
That despite the fact that 57.8 percent had been given antihypertensives, they reported in the April issue of the Journal of Pediatrics.
Factors that predicted higher blood pressure included age 12 or younger, black race, glomerular disease, and beginning dialysis before 2000 (P<0.0001 for all).
The cardiovascular challenges faced by children and teens with ESRD were highlighted in an editorial accompanying the study.
"A pediatric patient on dialysis has roughly the same cardiovascular risk as an 80-year-old without ESRD," wrote Sriram S. Narsipur, MD, of the State University of New York Upstate in Syracuse.
However, patient characteristics that influence blood pressure are incompletely understood, so Halbach's group analyzed data from the North American Pediatric Renal Trials and Collaborative Studies, which is a registry that enrolls patients from 150 centers.
To adjust for the effects of age, height, and sex on blood pressure, the researchers calculated standardized z scores for their analysis, which included 3,447 patients ages 1 to 21.