Hypertension in children with unilateral multicystic dysplastic kidney: a common but rarely diagnosed condition

Objective: In this study, we aim to determine the frequency of hypertension (HTN) by performing 24 hours (24h) ambulatory blood pressure monitoring (ABPM) in children with the unilateral multi-cystic disease of kidney (UMCDK) without ipsilateral and/or contra lateral kidney and/or urinary system anomalies.

Material and Methods: Twenty four patients with UMCDK and age-, and height-matched 20 healthy children were enrolled in this study. Blood pressure (BP) was measured by two approaches as follows: manuel BP and ABPM. Day-time (DT), night-time (NT) and 24h heart rate (HR), pulse pressure (PP), systolic and diastolic BP (SBP and DBP), median arterial pressure (MAP), and SBP and DBP loads (%) were compared.

Results: ABPM measurements showed the presence of masked HTN in twelve patients (45.8%), although two (8.3%) UMCDK patients were hypertensive with manual BP measurements. We detected that SBP loads (%) (DT, NT, and 24h) and DBP loads (%) (NT and 24h) were considerably higher than those of healthy children (p=0.030, p=0.012, p=0.005, p=0.012 and p=0.005, respectively).

Conclusion: Children with UMCDK are more likely to have masked HTN. Manual BP measurements are not accurate in ruling out HTN in children with UMCDK. ABPM contributes to more susceptible outcomes in proportion to manual BP measurement in these patients, and it should be considered in the clinical practice instead of manual BP measurements.

Cite this article as: Elmas AT, Zırhlı Selçuk Ş, Tabel Y. Hypertension in children with unilateral multicystic dysplastic kidney: A common but rarely diagnosed condition. Turk J Nephrol. 2022;31(4):363-367.