DISTRIBUTION AND CORRELATES OF CREATININE CLEARANCE IN CHILDREN AND ADOLESCENTS WITH BLOOD-PRESSURE ELEVATION

The kidney has been implicated as both an etiologic factor and as a ta rget organ in patients with essential hypertension. Renal function has not been studied extensively in children and adolescents with essenti al hypertension. Eighty-eight subjects, aged 6 to 23 years, with blood pressure persistently above the 90th percentile for age were studied. Creatinine clearance was determined from a single 24-hour urine colle ction. The mean creatinine clearance was 129.3 +/- 55.3 ml/min per 1.7 3 m2. Multiple regression analysis was used to investigate potential c orrelates of creatinine clearance. Because creatinine clearance was no t normally distributed, the logarithm of creatinine clearance was used as the dependent variable. Body mass index, resting heart rate, and b asal supine plasma renin activity were significant direct independent correlates. Peripheral vascular resistance at maximal exercise was an inverse correlate of the logarithm of creatinine clearance. These find ings are consistent with previous studies of adults and may provide th e basis for strategies to identify young patients with essential hyper tension who are at risk for the development of renal dysfunction.