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Vol. 58. Issue 6.
Pages 545-549 (01 June 2003)
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Vol. 58. Issue 6.
Pages 545-549 (01 June 2003)
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Monitorización ambulatoria de la presión arterial en pacientes con displasia renal multiquística
Ambulatory blood pressure monitoring in multicystic dysplastic kidney disease
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R. Pardo de la Vega
Corresponding author
rpardo@hcas.insalud.es

Correspondencia: Departamento de Pediatría. Hospital Central de Asturias. Celestino Villamil, s/n. 33006 Oviedo. Asturias. España.
, D. Herrero Morín, F.A. Ordóñez Álvarez, V. Martínez Suárez, F. Santos Rodríguez, S. Málaga Guerrero
Sección de Nefrología Pediátrica. Departamento de Pediatría. Hospital Central de Asturias. Universidad de Oviedo. España.
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Objetivo

Conocer el comportamiento de la presión arterial (PA) en pacientes con displasia renal multiquística mediante monitorización ambulatoria de la presión arterial (MAPA).

Pacientes y métodos

En 16 pacientes con displasia renal multiquística se llevó a cabo la MAPA durante 24 h, con un monitor oscilométrico SpacelabsÒ 90207 y manguitos adecuados a su talla y edad. Los pacientes desarrollaron su actividad diaria habitual, excepto ejercicio físico. Se consideró período de actividad de 8 a 20 h y período de reposo de 0 a 6 h. Se excluyeron los pacientes cuyo porcentaje de mediciones correctas era menor del 70 %. Para cada paciente se calcularon los valores medios de la presión arterial sistólica (PAS) y diastólica (PAD) para cada período. Para determinar la variabilidad circadiana de la PA se empleó el cociente PA reposo/PA actividad para la PAS y PAD, respectivamente. Los resultados se compararon de forma individual con estándares de MAPA en pacientes normotensos.

Resultados

Se incluyeron 14 pacientes (edad media, 16 6 3,1 años; límites, 6-27,6 años) en el estudio. Ninguno de los pacientes presentó hipertensión arterial (HTA) en las determinaciones casuales mediante esfigmomanómetro. Un paciente presentó HTA sistólica diurna. Cinco pacientes no realizaron descenso nictameral de la PA.

Conclusión

Es conveniente establecer un control de la PA en los pacientes con displasia renal multiquística, incluyendo la realización de MAPA, que puede poner de manifiesto alteraciones de la PA que podrían pasar desapercibidas en determinaciones casuales. Son necesarios estudios con tamaños muestrales amplios para poder establecer de forma más precisa la incidencia de HTA en este grupo de pacientes.

Palabras clave:
Displasia renal multiquística
Presión arterial ambulatoria
Niños
Objective

To evaluate blood pressure in a group of patients with multicystic dysplastic kidney (MDK) disease through ambulatory blood pressure (ABP) monitoring.

Patients and methods

ABP monitoring was performed in 16 patients with MDK disease using a Spacelabso90207 monitor and an appropriately sized armband. The patients performed their normal daily activities except physical exercise. The activity period was 8:00 am to 8:00 pm and the resting period was midnight to 6:00 am. Patients with a percentage of correct readings of less than 70 % were excluded. The mean systolic and diastolic blood pressures for each period were calculated. Circadian variability was determined by the ratio between mean systolic and diastolic values in the active and resting periods, respectively. The results were compared with ABP values in healthy children.

Results

Fourteen patients (mean age 16 6 3.1 years, range: 6-27.6) were included. No patients with hypertension were found through casual measurement. One patient had daytime systolic hypertension. Five patients presented an abnormal drop in blood pressure during sleep.

Conclusion

Blood pressure should be monitored in patients with MDK disease. ABP monitoring may detect alterations that can go unnoticed in casual determinations. Further studies with large samples are needed to establish the real prevalence of hypertension in these patients.

Key words:
Ambulatory blood pressure monitoring
Multicystic dysplastic kidney
Children
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BibliografÍa
[1.]
G.E. Hartman, L.M. Smolik, S.J. Shochat.
The dilemma of the multicystic dysplastic kidney.
Am J Dis Child, 140 (1986), pp. 925-928
[2.]
A.C. Gordon, D.F. Thomas, R.J. Arthur, H.C. Irving.
Multicystic dysplastic kidney: Is nephrectomy still appropriateα.
J Urol, 140 (1988), pp. 1231-1234
[3.]
N. Al Khaldi, A.R. Watson, J. Zuccollo, P. Twining, D.H. Rose.
Arch Dis Child, 70 (1994), pp. 520-522
[4.]
G. Orejas, S. Málaga, F. Santos, C. Rey, M.V. López, A. Merten.
Multicystic dysplastic kidney: Absence of complications in patients treated conservatively.
Child Nephrol Urol, 12 (1992), pp. 35-39
[5.]
G.C. Mingin, P. Gilhooly, H. Sadeghi-Nejad.
Transitional cell carcinoma in a multicystic dysplastic kidney.
J Urol, 163 (2000), pp. 544
[6.]
D.C. Gough, R.J. Postlethwaite, M.A. Lewis, J. Bruce.
Multicystic renal dysplasia dignosed in the antenatal period: A note of caution.
BJU Int, 76 (1976), pp. 244-248
[7.]
M.K. Hanna.
The multicystic dysplastic kidney.
Urology, 45 (1995), pp. 171
[8.]
E. Lurbe, J. Redon.
Ambulatory blood pressure monitoring in children and adolescents: The future.
J Hypertens, 18 (2000), pp. 1351-1354
[9.]
E. Lurbe, J. Redón, Y. Liao, J. Tacons, R.S. Cooper, V. Alvarez.
Ambulatory blood pressure monitoring in normotensive children.
J Hypertens, 12 (1994), pp. 1417-1423
[10.]
M. Soergel, M. Kirschstein, C. Busch, T. Danne, J. Gellermann, R. Holl, et al.
Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: A multicenter trial including 1141 subjects.
J Pediatr, 130 (1997), pp. 178-184
[11.]
J.J. O'Sullivan, G. Derrick, P. Griggs, R. Foxall, M. Aitkin, C. Wren.
Ambulatory blood pressure in schoolchildren.
Arch Dis Child, 80 (1999), pp. 529-532
[12.]
T. Seeman, U. John, K. Blahova, H. Vondrichova, J. Janda, J. Misselwitz.
Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney.
Eur J Pediatr, 160 (2001), pp. 78-83
[13.]
Grupo Cooperativo Español para el Estudio de los Factores de Riesgo Cardiovascular en la Infancia y Adolescencia.
Factores de riesgo cardiovascular en la infancia y adolescencia en España. Estudio RICARDIN II: Valores de referencia.
An Esp Pediatr, 43 (1995), pp. 11-17
[14.]
E. Lurbe, J. Redón, A. Kesani, J.M. Pascual, J. Tacons, V. Alvarez, et al.
Increase in nocturnal blood pressure and progression to microalbuminuria in type I diabetes.
N Engl J Med, 347 (2002), pp. 797-805
[15.]
G.J. Schwartz, G.B. Haycock, C.M. Edelmann Jr., A. Spitzer.
A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine.
Pediatrics, 58 (1976), pp. 259-263
[16.]
M.R. Susskind, K.S. Kim, L.R. King.
Hypertension and multicystic kidney.
Urology, 34 (1989), pp. 362-366
[17.]
N. Javadpour, E. Chelouhy, L. Moncada, I.M. Rosenthal, I.M. Bush.
Hypertension in a child caused by a multicystic kidney.
J Urol, 104 (1970), pp. 918-921
[18.]
J. Wacksman, L. Phipps.
Report of the Multicystic Kidney Registry: Preliminary findings.
J Urol, 150 (1993), pp. 1870-1872
[19.]
S. Sukthankar, A.R. Watson.
Unilateral multicystic dysplastic kidney disease: Defining the natural history. Anglia Paediatric Nephrourology Group.
Acta Paediatr, 89 (2000), pp. 811-813
[20.]
N.J. Webb, M.A. Lewis, J. Bruce, D.C. Gough, E.J. Ladusans, A.P. Thomson, et al.
Unilateral multicystic dysplastic kidney: The case for nephrectomy.
Arch Dis Child, 76 (1997), pp. 31-34
[21.]
R. Pardo, I. Málaga, B. Amil, F.A. Ordóñez, V. Martínez, F. Santos, et al.
Tratamiento conservador de la displasia renal multiquística durante la infancia.
Bol Pediatr, 42 (2002), pp. 71-75
[22.]
K. Kaneko, W. Kun, A. Yamataka, Y. Ohtomo, Y. Yamashiro, T. Miyano.
Is nephrectomy for neonatal multicystic dysplastic kidneys still inappropriateα.
Nephron, 86 (2000), pp. 376-377
[23.]
J.M. Jiménez-Hereza, M. Heras-Gironella, C. Loris-Pablo, J. Garagorri-Otero, M.J. Tardos-Solano.
Monitorización ambulatoria de la presión arterial en niños con nefropatía por reflujo de diferente grado.
An Esp Pediatr, 49 (1998), pp. 461-466
[24.]
N.R. Robles, B. Cancho, E. Crespo, C.E. Sánchez.
Uso de la monitorización ambulatoria de la presión arterial en enfermedad renal.
Nefrología, 21 (2001), pp. 65-70
[25.]
B. Csiky, T. Kovacs, L. Wagner, T. Vass, J. Nagy.
Ambulatory blood pressure monitoring and progression in patients with IgA nephropathy.
Nephrol Dial Transplant, 14 (1999), pp. 86-90
[26.]
J. Redon, Y. Liao, J.V. Lozano, A. Miralles, J.M. Pascual, R.S. Cooper.
Ambulatory blood pressure and microalbuminuria in essential hypertension: Role of circadian variability.
J Hypertens, 12 (1994), pp. 947-953
[27.]
V. Fanos, G. Sinaguglia, L. Vino, C. Pizzini, A. Portuese.
Multicystic dysplastic kidney and contralateral vesicoureteral reflux. Renal growth.
Minerva Pediatr, 53 (2001), pp. 95-98
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