BLOOD-PRESSURE AND RENAL-FUNCTION IN AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY-DISEASE

The purpose of this study was to identify hypertension in children and adolescents in an early stage of autosomal dominant polycystic kidney disease (ADPKD) by the application of ambulatory blood pressure monit oring (ABPM) over 24 h; 32 children and adolescents (mean age 13.3+/-4 .7 years) were examined. The diagnosis was based on family history and ultrasound examination. In 21 children ADPKD was confirmed by molecul ar genetic analysis. At the time of the study, 45% patients were asymp tomatic and all had glomerular filtration rates (GFRs) greater than or equal to 65 ml/min per 1.73 m(2). By ABPM, 11 patients (34%) were def ined as hypertensive (systolic or diastolic blood pressure > 95th perc entile), including 4 with an exclusive nocturnal hypertension. Of 7 pa tients with daytime hypertension, 4 had normal blood pressure by casua l measurements. The nocturnal dip in blood pressure was reduced in 2 p atients. Blood pressure correlated with renal size, but not with GFR, concentrating capacity, proteinuria, and plasma renin activity. The st udy reveals an early trend for increased blood pressure in children wi th ADPKD, requiring close supervision.