A reappraisal of risk factors for hypertension after pediatric acute kidney injury.
A reappraisal of risk factors for hypertension after pediatric acute kidney injury.
复制标题
小儿急性肾损伤后高血压危险因素的重新评估。
DOI：
10.1007/s00467-023-06222-3
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Gbadegesin,Rasheed
中科院分区：
文献类型：
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作者：
Patel,Mital;Hornik,Christoph;Diamantidis,Clarissa;Selewski,DavidT;Gbadegesin,Rasheed
背景急性肾损伤（AKI）在住院儿童中很常见，会增加慢性肾脏病（CKD）和高血压的风险，但对于 AKI 后小儿高血压的患者水平危险因素知之甚少。本研究的目的是评估 AKI 住院儿童新发高血压的患病率和危险因素，并更好地了解急性肾病 (AKD) 在高血压发展中的作用。 方法本研究是一个观察队列，纳入 2015 年至 2019 年一家三级护理儿童医院收治的所有 ≤18 岁诊断为 AKI 的儿童。高血压的定义是，根据性别、年龄、身高、问题清单上的高血压诊断或 AKI 后 90 天的抗高血压药物处方，血压≥95%。结果队列中共有 410 名儿童。其中，78 人 (19%) 在 AKI 后 90 天出现高血压。多变量逻辑回归模型确定 AKD、需要肾脏替代治疗、先天性心脏病和非肾脏实体器官移植是 AKI 后高血压的危险因素。结论 3 个月后发生高血压在 AKI 住院儿童中很常见，而 AKD、需要透析、先天性心脏病和非肾脏实体器官移植是 AKI 后高血压的重要危险因素 急性肾损伤。监测这些高危儿童的高血压发展对于减轻长期不利的肾脏和心血管结局至关重要。图解摘要更高分辨率版本的图解摘要可作为补充信息提供
BackgroundAcute kidney injury (AKI) is common in hospitalized children and increases the risk of chronic kidney disease (CKD) and hypertension, but little is known about the patient level risk factors for pediatric hypertension after AKI. The aims of this study are to evaluate the prevalence and risk factors for new onset hypertension in hospitalized children with AKI and to better understand the role of acute kidney disease (AKD) in the development of hypertension.MethodsThis study was an observational cohort of all children ≤ 18 years old admitted to a single tertiary care children’s hospital from 2015 to 2019 with a diagnosis of AKI. Hypertension was defined as blood pressure > 95th percentile for sex, age, height, diagnosis of hypertension on the problem list, or prescription of antihypertensive medication for > 90 days after AKI.ResultsA total of 410 children were included in the cohort. Of these, 78 (19%) developed hypertension > 90 days after AKI. A multivariable logistic regression model identified AKD, need for kidney replacement therapy, congenital heart disease, and non-kidney solid organ transplantation as risk factors for hypertension after AKI.ConclusionsIncident hypertension after 3 months is common among hospitalized children with AKI, and AKD, need for dialysis, congenital heart disease, and non-kidney solid organ transplant are significant risk factors for hypertension after AKI. Monitoring for hypertension development in these high-risk children is critical to mitigate long-term adverse kidney and cardiovascular outcomes.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information