High frequency of nocturnal hypertension in lupus nephritis: should ABPM be implemented in usual practice?

Mejía-Vilet, Juan M.; López-Hernández, Yesser J.; Matos, Mariedel Trujeque; Santander-Velez, J. Iván; Cano-Verduzco, Mayra L; Cruz, Cristino; Morales‐Buenrostro, Luis E.

doi:10.1007/s10067-019-04830-9

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Abnormal circadian BP patterns are common in children with specific underlying diagnoses. Nocturnal hypertension is common in children with sickle cell disease, 25 CKD, 26 obstructive sleep apnea, 27 systemic lupus erythematosus, 28 and autosomal dominant polycystic kidney disease 29 and in recipients of solid-organ transplants. 30 Some children with medical diagnoses often thought to have a more benign prognosis have significant abnormalities noted on ABPM: one-third of children with steroid-sensitive nephrotic syndrome have ambulatory hypertension and 72% have nocturnal hypertension 31 ; 50% of children born prematurely have abnormal nocturnal BP, 32 as do 82% of children with a solitary kidney.…”

Section: Usefulness In Chronic Conditionsmentioning

confidence: 99%

See 1 more Smart Citation

Ambulatory Blood Pressure Monitoring in Children and Adolescents: 2022 Update: A Scientific Statement From the American Heart Association

Flynn¹,

Urbina²,

Brady³

et al. 2022

Hypertension

122

189

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Use of ambulatory blood pressure monitoring in children and adolescents has markedly increased since publication of the last American Heart Association scientific statement on pediatric ambulatory blood pressure monitoring in 2014. In addition, there has also been significant expansion of the evidence base for use of ambulatory blood pressure monitoring in the pediatric population, including new data linking ambulatory blood pressure levels with the development of blood pressure–related target organ damage. Last, additional data have recently been published that enable simplification of the classification of pediatric ambulatory monitoring studies. This scientific statement presents a succinct review of this new evidence, guidance on optimal application of ambulatory blood pressure monitoring in the clinical setting, and an updated classification scheme for the interpretation of ambulatory blood pressure monitoring in children and adolescents. We also highlight areas of uncertainty where additional research is needed.

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Section: Usefulness In Chronic Conditionsmentioning

confidence: 99%

“…33 Nocturnal BP abnormalities have been associated with various measures of TOD in diverse patient populations, including type 1 diabetes. 26,28,34…”

Section: Usefulness In Chronic Conditionsmentioning

confidence: 99%

Ambulatory Blood Pressure Monitoring in Children and Adolescents: 2022 Update: A Scientific Statement From the American Heart Association

Flynn¹,

Urbina²,

Brady³

et al. 2022

Hypertension

122

189

View full text Add to dashboard Cite

show abstract

“…In new investigations, nocturnal hypertension and abnormal blood pressure patterns are common in LN patients. It may be related to degree of interstitial inflammation, salt sensitivity or advanced renal injury [13]. In our study, all patients were on antihypertensive drugs including angiotensin converting enzyme inhibitors or angiotensin receptor blockers from diagnosis of nephritis.…”

Section: Discussionmentioning

confidence: 91%

Pan-immune-inflammation value (PIIV) in Lupus Nephritis

Ulutaş

Çobankara

2023

Med Sci Discov

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Objective: Pan-immune-inflammation value (PIIV) is a newly defined marker that has been validated to predict the prognosis of several oncological diseases. We investigated whether PIIV at diagnosis could predict a reduced glomerular filtration rate (GFR) during follow-up in patients with lupus nephritis (LN). Material and Methods: We included 45 patients with biopsy-proven LN in this case-control study. PIIV at the diagnosis was calculated for each patient before starting any immunomodulatory and/or immune-suppressive drugs. The study group was classified into two subgroups: patients with a minimum 10 % decreased glomerular filtration rate (GFR) from baseline or preserved GFR. LN-specific indices, inflammation-related laboratory results at diagnosis, medications and developing comorbidities at the follow-up were also noted. Chi-Square Test was used to compare the subgroups. Associated factors were analyzed by logistic regression analysis. Statistically, the significance level was accepted as p˂0.05. Results: 77.8 % of all patients (n=35) were female, whereas 22.2 % were male. The mean age of the study group was 33.0 ± 13.4 years. The median follow-up period was 36 months (range: 4-108 months). A vast majority of patients (n=32, 71.1%) had class IV LN. GFR reduction was observed in eleven patients (n=11). The mean age at diagnosis, presence of developing hypertension, mean PIIV value, and PIIV >75% were significantly higher in patients with decreased GFR than the patients with preserved GFR (p=0.019, p=0.044, p=0.015, and p=0.011, respectively). In addition, the presence of developing HT and PIIV >75% were found to be statistically significant factors in the multivariate model (p=0.029 and p=0.022). Conclusion: An increased PIIV at baseline was independently associated with a reduction in GFR in LN patients. A high PIIV might become a new biomarker for the risk of GFR reduction and the need for improved/intensive treatment of these patients.

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“…MH due to nocturnal hypertension and abnormal circadian BP patterns is more common in children with sickle cell disease, CKD, obstructive sleep apnea, systemic lupus erythematosus, autosomal dominant polycystic kidney disease, and solidorgan transplant recipients. [61][62][63][64][65][66] In a systematic review by Thakkar et al, 67 the effect of patient comorbidities on MH prevalence was evaluated among 16 adult studies. This review found that adult MH occurred in 66.4% of adults with diabetes, 32.8% with CKD, 39% of renal transplant patients, and 30% of those with obstructive sleep apnea.…”

Section: Discussionmentioning

confidence: 99%

“…Children and adolescents with sustained hypertension are at increased risk of SCO (including LVH, elevated LVMI, cIMT, and PWV), microalbuminuria, and atherosclerosis compared with normotensive children. 10,12,14,[61][62][63][64][65][66][68][69][70][71] These risk factors are associated with adult cardiovascular diseases. 2,4,15,16 Among children with MH, the risk of adverse SCO and overt cardiovascular events is less clear.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Chung,

Robinson,

Sheffield

et al. 2023

Hypertension

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Masked hypertension (MH) occurs when office blood pressure is normal, but hypertension is confirmed using out-of-office blood pressure measures. Hypertension is a risk factor for subclinical cardiovascular outcomes, including left ventricular hypertrophy, increased left ventricular mass index, carotid intima media thickness, and pulse wave velocity. However, the risk factors for ambulatory blood pressure monitoring defined MH and its association with subclinical cardiovascular outcomes are unclear. A systematic literature search on 9 databases included English publications from 1974 to 2023. Pediatric MH prevalence was stratified by disease comorbidities and compared with the general pediatric population. We also compared the prevalence of left ventricular hypertrophy, and mean differences in left ventricular mass index, carotid intima media thickness, and pulse wave velocity between MH versus normotensive pediatric patients. Of 2199 screened studies, 136 studies (n=28 612; ages 4–25 years) were included. The prevalence of MH in the general pediatric population was 10.4% (95% CI, 8.00–12.80). Compared with the general pediatric population, the risk ratio (RR) of MH was significantly greater in children with coarctation of the aorta (RR, 1.91), solid-organ or stem-cell transplant (RR, 2.34), chronic kidney disease (RR, 2.44), and sickle cell disease (RR, 1.33). MH patients had increased risk of subclinical cardiovascular outcomes compared with normotensive patients, including higher left ventricular mass index (mean difference, 3.86 g/m 2.7 [95% CI, 2.51–5.22]), left ventricular hypertrophy (odds ratio, 2.44 [95% CI, 1.50–3.96]), and higher pulse wave velocity (mean difference, 0.30 m/s [95% CI, 0.14–0.45]). The prevalence of MH is significantly elevated among children with various comorbidities. Children with MH have evidence of subclinical cardiovascular outcomes, which increases their risk of long-term cardiovascular disease.

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High frequency of nocturnal hypertension in lupus nephritis: should ABPM be implemented in usual practice?

Cited by 7 publications

References 38 publications

Ambulatory Blood Pressure Monitoring in Children and Adolescents: 2022 Update: A Scientific Statement From the American Heart Association

Ambulatory Blood Pressure Monitoring in Children and Adolescents: 2022 Update: A Scientific Statement From the American Heart Association

Pan-immune-inflammation value (PIIV) in Lupus Nephritis

Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

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