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CLINICAL EPIDEMIOLOGY
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Masked Hypertension Associates with Left Ventricular Hypertrophy in Children with CKD

Mark Mitsnefes, Joseph Flynn, Silvia Cohn, Joshua Samuels, Tom Blydt-Hansen, Jeffrey Saland, Thomas Kimball, Susan Furth, Bradley Warady and for the CKiD Study Group
JASN January 2010, 21 (1) 137-144; DOI: https://doi.org/10.1681/ASN.2009060609
Mark Mitsnefes
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Joseph Flynn
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Silvia Cohn
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Joshua Samuels
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Tom Blydt-Hansen
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Jeffrey Saland
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Thomas Kimball
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Susan Furth
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Bradley Warady
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Abstract

Left ventricular hypertrophy (LVH) associates with increased risk for cardiovascular disease. Hypertension leads to LVH in adults, but its role in the pathogenesis of LVH in children is not as well established. To examine left ventricular mass and evaluate factors associated with LVH in children with stages 2 through 4 chronic kidney disease (CKD), we analyzed cross-sectional data from children who had baseline echocardiography (n = 366) and underwent ambulatory BP monitoring (n = 226) as a part of the observational Chronic Kidney Disease in Children (CKiD) cohort study. At baseline, 17% of children had LVH (11% eccentric and 6% concentric) and 9% had concentric remodeling of the left ventricle. On the basis of a combination of ambulatory and casual BP assessment (n = 198), 38% of children had masked hypertension (normal casual but elevated ambulatory BP) and 18% had confirmed hypertension (both elevated casual and ambulatory BP). There was no significant association between LVH and kidney function. LVH was more common in children with either confirmed (34%) or masked (20%) hypertension compared with children with normal casual and ambulatory BP (8%). In multivariable analysis, masked (odds ratio 4.1) and confirmed (odds ratio 4.3) hypertension were the strongest independent predictors of LVH. In conclusion, casual BP measurements alone are insufficient to predict the presence of LVH in children with CKD. The high prevalence of masked hypertension and its association with LVH supports early echocardiography and ambulatory BP monitoring to evaluate cardiovascular risk in children with CKD.

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  • Copyright © 2010 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 21 (1)
Journal of the American Society of Nephrology
Vol. 21, Issue 1
1 Jan 2010
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Masked Hypertension Associates with Left Ventricular Hypertrophy in Children with CKD
Mark Mitsnefes, Joseph Flynn, Silvia Cohn, Joshua Samuels, Tom Blydt-Hansen, Jeffrey Saland, Thomas Kimball, Susan Furth, Bradley Warady, for the CKiD Study Group
JASN Jan 2010, 21 (1) 137-144; DOI: 10.1681/ASN.2009060609

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Masked Hypertension Associates with Left Ventricular Hypertrophy in Children with CKD
Mark Mitsnefes, Joseph Flynn, Silvia Cohn, Joshua Samuels, Tom Blydt-Hansen, Jeffrey Saland, Thomas Kimball, Susan Furth, Bradley Warady, for the CKiD Study Group
JASN Jan 2010, 21 (1) 137-144; DOI: 10.1681/ASN.2009060609
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More in this TOC Section

  • Sex Differences in the Recognition, Monitoring, and Management of CKD in Health Care: An Observational Cohort Study
  • Association of Rosuvastatin Use with Risk of Hematuria and Proteinuria
  • Hurricanes and Mortality among Patients Receiving Dialysis
Show more Clinical Epidemiology

Cited By...

  • BP in Young Adults with CKD and Associations with Cardiovascular Events and Decline in Kidney Function
  • Prognostic Value of Ambulatory Blood Pressure Load in Pediatric CKD
  • The Enigma of Blood Pressure Measurement in Children with CKD
  • Twenty-Four-Hour Ambulatory Blood Pressure versus Clinic Blood Pressure Measurements and Risk of Adverse Outcomes in Children with CKD
  • Is Blood Pressure Improving in Children With Chronic Kidney Disease?: A Period Analysis
  • FGF23 and Left Ventricular Hypertrophy in Children with CKD
  • Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents
  • Vascular Stiffness in Children With Chronic Kidney Disease
  • Masked Uncontrolled Hypertension in CKD
  • Elevated Ejection-Phase Myocardial Wall Stress in Children With Chronic Kidney Disease
  • Advanced Parameters of Cardiac Mechanics in Children with CKD: The 4C Study
  • Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents: A Scientific Statement From the American Heart Association
  • BP Control and Left Ventricular Hypertrophy Regression in Children with CKD
  • Sexual Dimorphism in the Transition From Masked to Sustained Hypertension in Healthy Youths
  • Cardiovascular Disease in Children with Chronic Kidney Disease
  • Prevalence and Correlates of Multiple Cardiovascular Risk Factors in Children with Chronic Kidney Disease
  • Chronotherapy in Hypertension: A Pill at Night Makes Things Right?
  • Insights from the Chronic Kidney Disease in Children (CKiD) Study
  • Blood Pressure Control and Left Ventricular Mass in Children with Chronic Kidney Disease
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