Arterial hypertension in children after hemolytic uremic syndrome

Arterial hypertension (AH) is one of the most common complications which remains or redevelops after hemolytic uremic syndrome (HUS). AH that diagnosed in childhood represents a high risk of developing cardiovascular and renal disease in adult age. Aim: to determine the incidence and characteristics of AH in children after HUS; to assess circadian rhythm, blood pressure (BP) variability and the relationship between BP levels and other risk factors of unfavourable outcome of HUS. Materials and methods: the study included 59 children, aged 7 years (5.9; 8.3) and fol-low-up of HUS 5.12±2.07 years. All patients underwent daily blood pressure monitoring (ABPM), anthropometric measurements were performed, losses of protein and albumin in the urine were determined daily, glomerular filtration rate was calculated. Results: According to ABPM the prevalence of different forms of arterial hypertension in children after HUS was established: prehypertension was found in 10.2% of patients, white coat and masked AH were found in 13.6% and in 6.8% of patients. AH was detected more frequently in those patients who receiving dialysis in the acute period of HUS than without it (29.6% vs. 20%). High blood pressure was observed mainly at night time. In some patients obesity worsened systolic hypertension, which persisted throughout the day. Microalbuminuria was found in 50% of children with AH closely correlated with the severity of renal damage in the acute period of HUS (rs=0.4; p<0.05). Conclusions: Considering that AH in children after HUS is the predominantly nocturnal, 24h monitoring of blood pressure play a key role in its diagnosis. The detection of pathological microalbuminuria in this category of patients is the indication for ABPM, even at normal office BP.

артериальная гипертензия, гемолитико-уремический синдром (ГУС), дети, микроальбуминурия, суточное мониторирование артериального давления (СМАД), arterial hypertension, hemolytic uremic syndrome (HUS), children, microalbuminuria, 24 h ambulatory blood pressure monitoring (ABPM)

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