Abstract
The cardiac state and the prevalence of high blood pressure (BP) were analyzed in 21 pediatric patients (mean age 5.3±5.3 years) on chronic peritoneal dialysis (CPD), the aim being to specify the impact of hypervolemia in the etiology of hypertension. C- and N-terminal atrial natriuretic peptide (ANP-C, ANP-N) were measured as possible additional markers of hypervolemia. Baseline investigations were carried out 0.2 years after initiation of PD, and repeated after 0.9±0.2 years. Fifty-two percent of the patients had high BP, and in 40% the nocturnal BP decline was decreased. Left ventricular hypertrophy was present in 45%, but the systolic and diastolic functions of the heart were not impaired. Left ventricular mass correlated significantly with the severity of hypertension and with ANP-N (r=0.79, P<0.01 and r=0.66, P<0.01, Spearman rank correlation). Significant correlations were also found between the severity of hypertension and ANP-N and ANP-C (r=0.82, P<0.01 and r=0.66, P<0.01, Spearman rank correlation). High BP and cardiac impairment were more frequent in the younger and nephrectomized patients in whom volume overload seemed to be the most-important etiological factor. Our results suggest further that an ANP-N over 3.0 nmol/l combined with hypertension is strongly indicative of volume overload in patients on PD.
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Received: 31 May 2000 / Revised: 22 December 2000 / Accepted: 22 December 2000
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Hölttä, T., Happonen, JM., Rönnholm, K. et al. Hypertension, cardiac state, and the role of volume overload during peritoneal dialysis. Pediatr Nephrol 16, 324–331 (2001). https://doi.org/10.1007/s004670100562
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DOI: https://doi.org/10.1007/s004670100562