An increase in the survival of neonates with antenatal diagnosis of malformations was achieved by the recent technical advances in neonatal intensive care units. The aim of this article is to describe the experience with neonatal arterial hypertension, in newborns with nephro-urological malformations, in a tertiary care referral Nursery, in a period of 4 years. Newborn medical records from the Nursery Annex to the Maternity of Hospital das Clinicas, School of Medicine, University of Sao Paulo, with the diagnosis of nephro-urological malformations and systemic arterial hypertension (SAH) at hospital discharge, in a period from January 1999 to January 2003, were retrospectively analysed. Among 10.278 live newborns in the studied period, 15 (0.15%) newborns were compatible with our inclusion criteria. Of these 15 newborns, 12 (80%) were male and three were premature (20%). In relation to aetiology, 13 (87%) showed urological malformations, 1 (6%) chronic renal insufficiency secondary to kidney dysplasia and one (6%) autosomal recessive polycystic kidney disease. SAH control was achieved with monotherapy in eight patients (53%), five patients (33%) needed an association of two drugs (calcium-channel blocker and angiotensin converting enzyme (ACE) inhibitor), one child used three types of antihypertensive drugs (calcium-channel blocker, ACE inhibitor and hydrochlorothiazide) for pressoric control and one child's blood pressure (BP) was controlled exclusively by peritoneal dialysis. The incidence of nephro-urological malformations in our service during the studied period was 0.89%. SAH incidence among these newborns was 19%. Our data reinforce previous studies pointing to the necessity to consider children with nephro-urological malformations as a risk group for SAH, who should have the BP evaluated since the neonatal period.

2 (DRC > 2) em 24% (6/25); infecções do trato urinário (ITU) em 40% (10/25) e hipertensão portal (HP) em 32% dos casos (8/25). Das ultrassonografias abdominais iniciais, 80% demonstraram rins ecogênicos com cistos grosseiros e 64% detectaram fígado e vias biliares normais. Inibidores da ECA foram utilizados em 36% dos Pts, betabloqueadores em 20%, bloqueadores de canais de cálcio em 28% e diuréticos em 36% dos casos. Na análise final, após um tempo de acompanhamento médio de 152,2 meses (29,8 a 274,9 meses), HAS foi diagnosticada em 76% dos Pts, DRC > 2 em 44%, ITU em 52% e HP em 68%. CONCLUSÃO: As altas morbidade e mortalidade associadas à DRPAR justificam a construção de um banco de dados internacional, visando ao estabelecimento de um tratamento de suporte precoce.]]>

Introduction Nutritional state and growth are considered as prognostic markers of chronic peritoneal dialysis (PD) adequacy in pediatric patients. The euvolemia, blood pressure control, and metabolic and electrolytic equilibrium are parameters to be achieved by PD treatment. Objective To describe the chronic PD prescription parameters of a cohort of pediatric patients and to compare the obtained hemodynamic, antrophometric and adequacy results with those suggested by the literature. Methods Retrospective analysis based on clinical records evaluation of 30 pediatric patients undergoing PD for more than 6 months from January 1998 to May 2005. Results In the present study, 17/30 (56.7%) were boys. Chronic kidney disease was secondary to uropathy in 66.7% of the cases. The infusion volume was > 1,000 ml/m2 in 9 patients. The peritoneal membrane was characterized as high (27.8%), high-average (33.3%), low-average (22.2%) and low transporter (16.7%). The weekly urea Kt/V was > 2.1 in all the evaluated patients. Blood pressure parameters above the 95th percentile despite the use of antihypertensive medication were observed in 5/30 patients, four of whom with CKD secondary to glomerulopathy. The initial and final Body Mass Index and weight for height ratio were preserved in 83.3% (25/30) patients. Conclusion Elevated indexes of small solutes removal are easily attained in pediatric PD patients and do not imply optimal clinical management do not imply optimal climanagement.

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