Our study aimed to assess active renin concentration in children with primary hypertension. Thus, we evaluated active renin concentration, clinical parameters, office and ambulatory blood pressure, and biochemical parameters in 51 untreated adolescents with primary hypertension (median: 14.4 [interquartile range—IQR: 13.8–16.8] years) and 45 healthy adolescents. Active renin concentration did not differ between patients with hypertension and healthy children (median: 28.5 [IQR: 21.9–45.2] vs. 24.9 [IQR: 16.8–34.3] [pg/mL], p = 0.055). In the whole group of 96 children, active renin concentration correlated positively with serum potassium and office and ambulatory systolic and diastolic blood pressures. Among children with hypertension, patients with isolated systolic hypertension had lower renin concentration than patients with systolic-diastolic hypertension (26.2 [IQR: 18.6–34.2] vs. 37.8 [IQR: 27.0–49.6] [pg/mL], p = 0.014). The active renin concentration did not differ between patients with isolated systolic hypertension and healthy children. In multivariate analysis, diastolic blood pressure Z-score (beta = 0.238, 95 confidence interval [0.018–0.458], p = 0.035) was the only predictor of active renin concentration in the studied children. We concluded that active renin concentration is positively associated with blood pressure and potassium in children, and diastolic blood pressure was the strongest predictor of renin level. Patients with isolated systolic hypertension may differ from patients with systolic-diastolic hypertension in less severe activation of the renin-angiotensin-aldosterone system.

Introduction: Recombinant human growth hormone (rhGH) treatment has been a well-established means of dealing with chronic kidney disease (CKD)-related short-stature for over 25 years. The aim of this study was to evaluate the safety, efficacy, metabolic effects, and factors influencing response to rhGH treatment in Poland. Material and methods: 156 non-dialyzed children with different stages of CKD were analysed regarding anthropometric features, biochemical parameters, calcium-phosphorus metabolism, bone mineral density (BMD), and CKD progression. The analysis comprised 24 months of treatment Results: The median height velocity during the whole course of treatment in the analysed group was 8 cm/year. In the first year of treatment, it was significantly faster than in the second year (9.5 cm/year and 7.6 cm/year, respectively, p < 0.01) and did not differ between children with CKD stage 2-3 (group A) and with CKD stage 4-5 (group B). Age of therapy onset correlated negatively with total ΔheightSDS (r = -0.21, p < 0.05). Throughout the treatment we observed a decrease of hypercalcemia (both groups) and an increase of hyperphosphatemia (group A). In the first year parathyroid hormone (PTH), IGF-1, CaxP, and ALP increased. In the second year PTH, IGF-1, and CaxP stabilized, and ALP decreased. ΔheightSDS correlated negatively with initial and mean serum cholesterol. Serum triglyceride concentration increased in the course of treatment. After 24 months, total body BMD increased in group A, and lumbar spine BMD increased in both groups (A and B). The mean decrease of glomerular filtration rate was 2.5 ml/min/1.73 m 2 /year. Conclusions: rhGH treatment is safe and effective, and should include the youngest CKD patients. Our results suggest that there might be a relationship between rhGH treatment and lipid profile, which necessitates further research.

Background: Elevated blood pressure and proteinuria are well-established risk factors for chronic kidney disease (CKD) progression in children. This study aimed to analyze risk factors for CKD progress, emphasizing detailed ambulatory blood pressure (ABPM) data. Methods: In 55 children with CKD II–V, observed for ≥1 year or until initiation of kidney replacement therapy, we analyzed ABPM, clinical, and biochemical parameters. Results: At the beginning, the glomerular filtration rate (eGFR) was 66 (interquartile range—IQR: 42.8–75.3) mL/min/1.73 m2, and the observation period was 27 (16–36) months. The mean eGFR decline was 2.9 ± 5.7 mL/min/1.73 m2/year. eGFR decline correlated (p < 0.05) with age (r = 0.30), initial proteinuria (r = 0.31), nighttime systolic and mean blood pressure (r = 0.27, r = 0.29), and systolic and diastolic blood pressure dipping (r = −0.37, r = −0.29). There was no relation between mean arterial pressure during 24 h (MAP 24 h Z-score) and eGFR decline and no difference in eGFR decline between those with MAP 24 h < and ≥50 th percentile. In multivariate analysis, systolic blood pressure dipping (beta = −0.43), presence of proteinuria (beta = −0.35), and age (beta = 0.25) were predictors of eGFR decline. Conclusions: Systolic blood pressure dipping may be a valuable indicator of CKD progression in children.