The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 1
Urinary markers of renal damage in hypertensive children diagnosed with ambulatory blood pressure monitoring
Division of Pediatric Nephrology1, Department of Pediatrics and Departments of 2Biochemistry, and 3Bioistatistics, Adnan
Menderes University Faculty of Medicine, Aydın, Turkey. E-mail: igirisgen78@hotmail.com
Primary hypertension is the most important risk factor for chronic kidney
disease in adulthood. However, the role of hypertension in kidney damage in
childhood is not known exactly. The aim of this study was to evaluate the
ambulatory blood pressure measurements of healthy children diagnosed as
hypertensive with routine office blood pressure monitoring and to investigate
the effects of primary hypertension on the kidney. Fifty-six patients who had
blood pressure higher than 90th percentile during their well-child follow-up
and 27 healthy children with normal blood pressure were included in the
study. Twenty-four hour blood pressure measurements were recorded for
all the patients. Microalbumin and N-acetyl-β-D-glucosaminidase (NAG)
levels in the 24-hour urine were determined in the study groups. According
to the results of ambulatory blood pressure measurements, 52% of the
patients were diagnosed as white coat hypertension. The patients and the
white coat hypertensive group had higher levels of urinary NAG than the
control group. No significant difference was found in the levels of urinary
microalbumin excretion between the primary hypertension and control groups.
It was thought that ambulatory blood pressure measurement was necessary
for the true diagnosis of hypertension in children, and further, that primary
and white coat hypertension had effects on kidney damage in childhood. It
is suggested that urine NAG excretion might be used as an early sign of
hypertension-induced renal damage.
Keywords :
children, hypertension, ambulatory blood pressure monitoring, renal
damage, N-acetyl-β-D-glucosaminidase.