Publication:
Incidence and Risk Factors for Hypertension among Children with Nephrotic Syndrome.

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dc.contributor.authorRobinson, Cal
dc.contributor.authorWagner, Stéphanie
dc.contributor.authorAman, Nowrin
dc.contributor.authorBanh, Tonny H M
dc.contributor.authorDhillon, Vaneet
dc.contributor.authorLanglois, Valerie
dc.contributor.authorLicht, Christoph
dc.contributor.authorMcKay, Ashlene
dc.contributor.authorNoone, Damien
dc.contributor.authorPearl, Rachel
dc.contributor.authorRadhakrishnan, Seetha
dc.contributor.authorTeoh, Chia Wei
dc.contributor.authorVasilevska-Ristovska, Jovanka
dc.contributor.authorParekh, Rulan S
dc.date.accessioned2025-01-03T10:36:06Z
dc.date.available2025-01-03T10:36:06Z
dc.date.issued2024-12-20
dc.description.abstractObjectives To determine incidence and risk factors for hypertension in childhood nephrotic syndrome.Study Design Using data from the Insight into Nephrotic Syndrome (INSIGHT) study, a prospective observational childhood nephrotic syndrome cohort from Toronto, Canada, we evaluated hypertension incidence and time-to-hypertension overall and stratified by 1) steroid-resistance or steroid-sensitivity, and 2) frequently-relapsing, steroid dependent, or infrequently-relapsing. Hypertension was defined as stage 1-2 hypertensive blood pressure on two consecutive visits or anti-hypertensive medication initiation.Results We included 748 children with nephrotic syndrome from 1996 to 2023. Median (quartile 1-3 [Q1-3]) age at diagnosis was 4 (2.8-6) years, 473 (63%) children were male, and 240 (32%) were of South Asian ethnicity. Forty (5%) children were steroid-resistant, 177 (24%) steroid-dependent, 113 (15%) frequently-relapsing, and 418 (56%) infrequently-relapsing. Median follow-up was 5.2 years (Q1-3 3.0-9.3). During follow-up, 393 (53%) children developed hypertension or were initiated on an anti-hypertensive medication (incidence rate 8.2 per 100 person-years, 95%CI 7.4-9.1). Hypertension was more common among children steroid-resistance than steroid-sensitivity (70% vs. 52%; adjusted HR 1.47, 95%CI 1.00-2.17). Hypertension was also more common in children who were steroid-dependent (67%; adjusted HR 1.81, 95%CI 1.43-2.30) and frequently-relapsing (63%; adjusted HR 1.64, 95%CI 1.23-2.18), than infrequently-relapsing (42%). Among steroid-sensitive patients, higher BMI Z-score and academic center were also significant hypertension risk factors.Conclusions Half of children with nephrotic syndrome develop hypertension. Children who are steroid-resistant, steroid-dependent, frequently-relapsing or have obesity are at greatest risk. Close blood pressure surveillance is justified to identify and treat hypertension.
dc.description.sponsorshipClinic of Paediatric Medicine
dc.identifier.doi10.48620/78810
dc.identifier.pmid39710174
dc.identifier.publisherDOI10.1016/j.jpeds.2024.114443
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/195070
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofThe Journal of pediatrics
dc.relation.issn1097-6833
dc.subjectNephrotic syndrome
dc.subjectarterial hypertension
dc.subjectblood pressure
dc.subjectchildren
dc.subjecthypertension
dc.subjectpediatric
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleIncidence and Risk Factors for Hypertension among Children with Nephrotic Syndrome.
dc.typearticle
dspace.entity.typePublication
oaire.citation.startPage114443
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