Skip to main content
Erschienen in: Pediatric Nephrology 3/2012

01.03.2012 | Original Article

Microalbuminuria in children with primary and white-coat hypertension

verfasst von: Tomáš Seeman, Michael Pohl, Daniela Palyzova, Ulrike John

Erschienen in: Pediatric Nephrology | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Microalbuminuria serves as an early marker of hypertension-related renal damage in adults. However, data on the prevalence of microalbuminuria in paediatric hypertensive patients in general and in children with white-coat hypertension (WCH) specifically are lacking. The aim of our study was to investigate the prevalence of microalbuminuria in children with primary hypertension (PH) and WCH, respectively. This was a retrospective case review of children with PH and WCH treated at three paediatric nephrology centres. Untreated children with either form of hypertension for whom measurements of urinary albumin excretion (UAE) had been performed were enrolled in the study. The study cohort comprised 52 children (39 boys) with hypertension (26 children with PH, 26 with WCH). Microalbuminuria (>3.2 mg/mmol creatinine) was present in 20% of children with PH and none of the children with WCH (p < 0.01). Children with PH had a higher median UAE than those with WCH (1.27 ± 1.92 vs. 0.66 ± 0.46 mg/mmol creatinine, p < 0.05). Based on these results, we suggest that children with PH have an increased prevalence of microalbuminuria, while children with WCH show no signs of hypertension-related renal damage.
Literatur
1.
Zurück zum Zitat Yudkin JS, Forrest RD, Jackson CA (1988) Microalbuminuria as predictor of vascular disease in nondiabetic subjects. Islington Diabetes Survey. Lancet 2:530–533PubMedCrossRef Yudkin JS, Forrest RD, Jackson CA (1988) Microalbuminuria as predictor of vascular disease in nondiabetic subjects. Islington Diabetes Survey. Lancet 2:530–533PubMedCrossRef
2.
Zurück zum Zitat Pontremoli R, Sofia A, Ravera M, Nicolella C, Viazzi F, Tirotta A, Ruello N, Tomolillo C, Castello C, Grillo G, Sacchi G, Deferrari G (1997) Prevalence and clinical correlates of microalbuminuria in essential hypertension. The MAGIC study. Hypertension 30:1135–1143PubMed Pontremoli R, Sofia A, Ravera M, Nicolella C, Viazzi F, Tirotta A, Ruello N, Tomolillo C, Castello C, Grillo G, Sacchi G, Deferrari G (1997) Prevalence and clinical correlates of microalbuminuria in essential hypertension. The MAGIC study. Hypertension 30:1135–1143PubMed
3.
Zurück zum Zitat Pontremoli R, Leoncinii G, Ravera M, Viazzi F, Vettoretti S, Ratto E, Parodi D, Tomolillo C, Deferrari G (2002) Microalbuminuria, cardiovascular and renal risk in primary hypertension. J Am Soc Nephrol 13:S169–S172PubMedCrossRef Pontremoli R, Leoncinii G, Ravera M, Viazzi F, Vettoretti S, Ratto E, Parodi D, Tomolillo C, Deferrari G (2002) Microalbuminuria, cardiovascular and renal risk in primary hypertension. J Am Soc Nephrol 13:S169–S172PubMedCrossRef
4.
Zurück zum Zitat Palatini P, Graniero GR, Mormino P, Mattarei M, Sanzuoi F, Cignacco GB, Gregori S, Garavelli G, Pegoraro F, Maraglino G, Bortolazzi A, Accurso V, Dorigatti F, Graniero F, Gelisio R, Businaro R, Vriz O, Dal Follo M, Camarotto A, Pessina AC (1996) Prevalence and clinical correlates of microalbuminuria in stage I hypertension. Results from the Hypertension and Ambulatory Recording Venetia Study (HARVEST Study). Am J Hypertens 9:334–341PubMedCrossRef Palatini P, Graniero GR, Mormino P, Mattarei M, Sanzuoi F, Cignacco GB, Gregori S, Garavelli G, Pegoraro F, Maraglino G, Bortolazzi A, Accurso V, Dorigatti F, Graniero F, Gelisio R, Businaro R, Vriz O, Dal Follo M, Camarotto A, Pessina AC (1996) Prevalence and clinical correlates of microalbuminuria in stage I hypertension. Results from the Hypertension and Ambulatory Recording Venetia Study (HARVEST Study). Am J Hypertens 9:334–341PubMedCrossRef
5.
Zurück zum Zitat Biggazzi R, Bianchi S, Baldari D, Campese VM (1998) Microalbuminuria predicts cardiovascular events and renal insufficiency in patients with essential hypertension. J Hypertens 16:1325–1333CrossRef Biggazzi R, Bianchi S, Baldari D, Campese VM (1998) Microalbuminuria predicts cardiovascular events and renal insufficiency in patients with essential hypertension. J Hypertens 16:1325–1333CrossRef
6.
Zurück zum Zitat Assadi F (2008) Relation of left ventricular hypertrophy to microalbuminuria and C-reactive protein in children and adolescents with essential hypertension. Pediatr Cardiol 29:580–584PubMedCrossRef Assadi F (2008) Relation of left ventricular hypertrophy to microalbuminuria and C-reactive protein in children and adolescents with essential hypertension. Pediatr Cardiol 29:580–584PubMedCrossRef
7.
Zurück zum Zitat Sorof JM, Turner J, Martin DS, Garcia K, Garami Z, Alexandrov AV, Wan F, Portman RJ (2004) Cardiovascular risk factors and sequelae in hypertensive children identified by referral versus school-based screening. Hypertension 43:214–218PubMedCrossRef Sorof JM, Turner J, Martin DS, Garcia K, Garami Z, Alexandrov AV, Wan F, Portman RJ (2004) Cardiovascular risk factors and sequelae in hypertensive children identified by referral versus school-based screening. Hypertension 43:214–218PubMedCrossRef
8.
Zurück zum Zitat Belsha CW, Wells TG, McNiece K, Seib PM, Plummer JK, Berry PL (1998) Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens 11:410–417PubMedCrossRef Belsha CW, Wells TG, McNiece K, Seib PM, Plummer JK, Berry PL (1998) Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens 11:410–417PubMedCrossRef
9.
Zurück zum Zitat Stergiou GS, Yiannes NJ, Rarra VC, Alamara CV (2005) White-coat hypertension and masked hypertension in children. Blood Press Monit 10:297–300PubMedCrossRef Stergiou GS, Yiannes NJ, Rarra VC, Alamara CV (2005) White-coat hypertension and masked hypertension in children. Blood Press Monit 10:297–300PubMedCrossRef
10.
Zurück zum Zitat Stabouli S, Kotsis V, Toumanidis S, Papamichael C, Constantopoulos A, Zakopoulos N (2005) White-coat and masked hypertension in children: association with target organ damage. Pediatr Nephrol 20:1151–1155PubMedCrossRef Stabouli S, Kotsis V, Toumanidis S, Papamichael C, Constantopoulos A, Zakopoulos N (2005) White-coat and masked hypertension in children: association with target organ damage. Pediatr Nephrol 20:1151–1155PubMedCrossRef
11.
Zurück zum Zitat Kavey RE, Kveselis DA, Atallah N, Smith FC (2007) White coat hypertension in childhood: Evidence for end-organ effect. J Pediatr 150:491–497PubMedCrossRef Kavey RE, Kveselis DA, Atallah N, Smith FC (2007) White coat hypertension in childhood: Evidence for end-organ effect. J Pediatr 150:491–497PubMedCrossRef
12.
Zurück zum Zitat Lande MB, Meagher CC, Gross Fisher S, Belani P, Wang H, Rashid M (2008) Left ventricular mass index in children with white coat hypertension. J Pediatr 153:50–54PubMedCrossRef Lande MB, Meagher CC, Gross Fisher S, Belani P, Wang H, Rashid M (2008) Left ventricular mass index in children with white coat hypertension. J Pediatr 153:50–54PubMedCrossRef
13.
Zurück zum Zitat National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576CrossRef
14.
Zurück zum Zitat Soergel M, Kirchstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W (1997) Oscillometric twenty-four hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 130:178–184PubMedCrossRef Soergel M, Kirchstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W (1997) Oscillometric twenty-four hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 130:178–184PubMedCrossRef
15.
Zurück zum Zitat Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, Kuznetsova T, Laurent S, Mancia G, Morales-Olivas F, Rascher W, Redon J, Schaefer F, Seeman T, Stergiou G, Wühl E, Zanchetti A, European Society of Hypertension (2009) Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 27:1719–1742PubMedCrossRef Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, Kuznetsova T, Laurent S, Mancia G, Morales-Olivas F, Rascher W, Redon J, Schaefer F, Seeman T, Stergiou G, Wühl E, Zanchetti A, European Society of Hypertension (2009) Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 27:1719–1742PubMedCrossRef
16.
Zurück zum Zitat Cole TJ, Green PJ (1992) Smoothing reference centile curves—the LMS method and penalized likelihood. Stat Med 11:1305–1319PubMedCrossRef Cole TJ, Green PJ (1992) Smoothing reference centile curves—the LMS method and penalized likelihood. Stat Med 11:1305–1319PubMedCrossRef
17.
Zurück zum Zitat Wühl E, Witte K, Soergel M, Mehls O, Schaefer F, Kirchstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W, German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20:1995–2007CrossRef Wühl E, Witte K, Soergel M, Mehls O, Schaefer F, Kirchstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W, German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20:1995–2007CrossRef
18.
Zurück zum Zitat Seeman T, Patzer L, John U, Dusek J, Vondrak K, Janda J, Misselwitz J (2006) Blood pressure, renal function, and proteinuria in children with unilateral renal agenesis. Kidney Blood Press Res 29:210–215PubMedCrossRef Seeman T, Patzer L, John U, Dusek J, Vondrak K, Janda J, Misselwitz J (2006) Blood pressure, renal function, and proteinuria in children with unilateral renal agenesis. Kidney Blood Press Res 29:210–215PubMedCrossRef
19.
Zurück zum Zitat Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration to estimate glomerular filtration rate in infancy, childhood and adolescents. Pediatr Clin North Am 34:571–590PubMed Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration to estimate glomerular filtration rate in infancy, childhood and adolescents. Pediatr Clin North Am 34:571–590PubMed
20.
Zurück zum Zitat Martinez MA, Garcia-Puig J, Martin JC, Guallar-Castillon P, Aguirre de Carcer A, Torre A, Armada A, Nevado E, Madero RS (1999) Frequency and determinants of white coat hypertension in mild to moderate hypertension: a primary care-based study. Monitorization Ambulatoria de la Presion Arterial (MAPA)—Area 5 Working Group. Am J Hypertens 12:251–259PubMedCrossRef Martinez MA, Garcia-Puig J, Martin JC, Guallar-Castillon P, Aguirre de Carcer A, Torre A, Armada A, Nevado E, Madero RS (1999) Frequency and determinants of white coat hypertension in mild to moderate hypertension: a primary care-based study. Monitorization Ambulatoria de la Presion Arterial (MAPA)—Area 5 Working Group. Am J Hypertens 12:251–259PubMedCrossRef
21.
Zurück zum Zitat Rademacher ER, Sinaiko AR (2009) Albuminuria in children. Curr Opin Nephrol Hypertens 18:246–251PubMedCrossRef Rademacher ER, Sinaiko AR (2009) Albuminuria in children. Curr Opin Nephrol Hypertens 18:246–251PubMedCrossRef
22.
Zurück zum Zitat Assadi F (2007) Effect of microalbuminuria lowering on regression of left ventricular hypertrophy in children and adolescents with essential hypertension. Pediatr Cardiol 28:27–33PubMedCrossRef Assadi F (2007) Effect of microalbuminuria lowering on regression of left ventricular hypertrophy in children and adolescents with essential hypertension. Pediatr Cardiol 28:27–33PubMedCrossRef
23.
Zurück zum Zitat Devereux RB, Okin PM, Roman MJ (1998) Pre-clinical cardiovascular disease and surrogate end-points in hypertension: does race influence target organ damage independent of blood pressure? Ethn Dis 8:138–148PubMed Devereux RB, Okin PM, Roman MJ (1998) Pre-clinical cardiovascular disease and surrogate end-points in hypertension: does race influence target organ damage independent of blood pressure? Ethn Dis 8:138–148PubMed
24.
Zurück zum Zitat Ogunniyi MO, Croft JB, Greenlund KJ, Giles WH, Mensah GA (2010) Racial/ethnic differences in microalbuminuria among adults with prehypertension and hypertension: National Health and Nutrition Examination Survey (NHANES), 1999–2006. Am J Hypertens 23:859–864PubMedCrossRef Ogunniyi MO, Croft JB, Greenlund KJ, Giles WH, Mensah GA (2010) Racial/ethnic differences in microalbuminuria among adults with prehypertension and hypertension: National Health and Nutrition Examination Survey (NHANES), 1999–2006. Am J Hypertens 23:859–864PubMedCrossRef
25.
Zurück zum Zitat Verdecchia P, Reboldi GP, Angeli F, Schillaci G, Schwartz JE, Pickering TG, Imai Y, Ohkubo T, Kario K (2005) Short- and long-term incidence of stroke in white-coat hypertension. Hypertension 45:203–208PubMedCrossRef Verdecchia P, Reboldi GP, Angeli F, Schillaci G, Schwartz JE, Pickering TG, Imai Y, Ohkubo T, Kario K (2005) Short- and long-term incidence of stroke in white-coat hypertension. Hypertension 45:203–208PubMedCrossRef
26.
Zurück zum Zitat Pickering TG, Coats A, Mallion JM, Mancia G, Verdecchia P (1999) Blood pressure monitoring. Task force V: White-coat hypertension. Blood Press Monit 4:333–341PubMed Pickering TG, Coats A, Mallion JM, Mancia G, Verdecchia P (1999) Blood pressure monitoring. Task force V: White-coat hypertension. Blood Press Monit 4:333–341PubMed
27.
Zurück zum Zitat Cavallini MC, Roman MJ, Pickering TG, Schwart JE, Pini R, Devereux RB (1995) Is white coat hypertension associated with arterial disease or left ventricular hypertrophy? Hypertension 26:413–419PubMed Cavallini MC, Roman MJ, Pickering TG, Schwart JE, Pini R, Devereux RB (1995) Is white coat hypertension associated with arterial disease or left ventricular hypertrophy? Hypertension 26:413–419PubMed
28.
Zurück zum Zitat Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Porcellati C (1998) White-coat hypertension: not guilty when correctly defined. Blood Press Monit 3:147–152PubMed Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Porcellati C (1998) White-coat hypertension: not guilty when correctly defined. Blood Press Monit 3:147–152PubMed
29.
Zurück zum Zitat Martínez MA, Moreno A, Aguirre de Cárcer A, Cabrera R, Rocha R, Torre A, Nevado A, Ramos T, Neri J, Antón G, Miranda I, Fernández P, Rodríguez E, Miquel A, Martínez JL, Rodríguez M, Eisman C, Puig JG, MAPA–Madrid Working Group (2001) Frequency and determinants of microalbuminuria in mild hypertension: a primary-care-based study. J Hypertens 19:319–326CrossRef Martínez MA, Moreno A, Aguirre de Cárcer A, Cabrera R, Rocha R, Torre A, Nevado A, Ramos T, Neri J, Antón G, Miranda I, Fernández P, Rodríguez E, Miquel A, Martínez JL, Rodríguez M, Eisman C, Puig JG, MAPA–Madrid Working Group (2001) Frequency and determinants of microalbuminuria in mild hypertension: a primary-care-based study. J Hypertens 19:319–326CrossRef
30.
Zurück zum Zitat Hoegholm A, Bang LE, Kristensen KS, Nielsen JW, Holm J (1994) Microalbuminuria in 411 untreated individuals with established hypertension, white coat hypertension, and normotension. Hypertension 24:101–105PubMed Hoegholm A, Bang LE, Kristensen KS, Nielsen JW, Holm J (1994) Microalbuminuria in 411 untreated individuals with established hypertension, white coat hypertension, and normotension. Hypertension 24:101–105PubMed
31.
Zurück zum Zitat Palatini P, Mormino P, Santonastaso M, Mos L, Dal Follo M, Zanata G, Pessina AC (1998) Target-organ damage in stage I hypertensive subjects with white coat and sustained hypertension: results from the HARVEST study. Hypertension 31:57–63PubMed Palatini P, Mormino P, Santonastaso M, Mos L, Dal Follo M, Zanata G, Pessina AC (1998) Target-organ damage in stage I hypertensive subjects with white coat and sustained hypertension: results from the HARVEST study. Hypertension 31:57–63PubMed
32.
Zurück zum Zitat Wiinberg N, Bang LE, Wachtell K, Larsen J, Olsen MH, Tuxen C, Hildebrandt PR, Rokkedal J, Ibsen H, Devereux RB (2004) 24-h ambulatory blood pressure in patients with ECG-determined left ventricular hypertrophy: left ventricular geometry and urinary albumin excretion—a LIFE substudy. J Hum Hypertens 18:391–396PubMedCrossRef Wiinberg N, Bang LE, Wachtell K, Larsen J, Olsen MH, Tuxen C, Hildebrandt PR, Rokkedal J, Ibsen H, Devereux RB (2004) 24-h ambulatory blood pressure in patients with ECG-determined left ventricular hypertrophy: left ventricular geometry and urinary albumin excretion—a LIFE substudy. J Hum Hypertens 18:391–396PubMedCrossRef
Metadaten
Titel
Microalbuminuria in children with primary and white-coat hypertension
verfasst von
Tomáš Seeman
Michael Pohl
Daniela Palyzova
Ulrike John
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Nephrology / Ausgabe 3/2012
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-2019-2

Weitere Artikel der Ausgabe 3/2012

Pediatric Nephrology 3/2012 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.