Renal Concentrating
Capacity is Linked to Blood Pressure in Children with Autosomal
Dominant Polycystic Kidney Disease
T. SEEMAN, J. DUŠEK, K. VONDRÁK, K. BLÁHOVÁ, E. ŠIMKOVÁ, J.
KREISINGER, P. DVOŘÁK, M. KYNČL1, Z. HŘÍBAL1,
J. JANDA
First Department of Pediatrics and 1Department of
Radiology, University Hospital Motol, Prague, Czech Republic
Received September 15, 2003
Accepted February 19, 2004
Summary
Impaired glomerular filtration rate (GFR) is a risk factor for
the development of hypertension in patients with autosomal
dominant polycystic kidney disease (ADPKD). However, markers of
tubular function were not tested whether they are linked to
hypertension or blood pressure (BP) level. The aim of our study
was to investigate the relationship between renal concentrating
capacity and BP in children with ADPKD. Fifty-three children
(mean age 11.84.4 years) were investigated. Standardized renal
concentrating capacity test was performed after nasal drop
application of desmopressin, BP was measured by ambulatory BP
monitoring (ABPM). Renal concentrating capacity was decreased in
58 % of children. The prevalence of hypertension was
significantly higher in children with decreased renal
concentrating capacity (35 %) than in children with normal renal
concentrating capacity (5 %) (p0.05). Significant negative
correlations were found between renal concentrating capacity,
ambulatory BP and number of renal cysts (r = –0.29 to
–0.39, p0.05 to p0.01). In conclusion, the concentrating
capacity is decreased in about half of the patients and is
linked to BP. Decreased renal concentrating capacity should be
considered as an early marker of functional impairment in ADPKD
and a further risk factor for hypertension.
Key words
Renal concentrating capacity test • Autosomal dominant
polycystic kidney disease • Blood pressure • Hypertension •
Children
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