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Children with Resolved Glomerular Disease at Risk for Adult Hypertension?

Summary and Comment |
April 9, 2014

Children with Resolved Glomerular Disease at Risk for Adult Hypertension?

  1. F. Bruder Stapleton, MD

A history of resolved childhood glomerular disease was associated with increased risk for adult hypertension.

  1. F. Bruder Stapleton, MD

Many children with glomerulonephritis and nephrotic syndrome appear to have complete resolution of signs and symptoms of disease. To determine whether these children are at increased risk for subsequent hypertension in adulthood, researchers compared 37,880 men in the Israeli military with no history of glomerular disease at age 17 years and 264 military men with a history and physical exam compatible with resolved glomerular disease at age 17 years.

During a mean follow-up of 18 years (mean age, 36 years), 13.6% of men with histories of resolved glomerular disease developed hypertension versus 7.4% of those without such history (adjusted hazard ratio, 1.67). Mean values for body habitus, serum creatinine, and history of smoking did not differ between the two groups. During follow-up, 76% of men had available creatinine values; 4 men (2%) with resolved glomerular disease had an estimated glomerular filtration rate <60 mL/min/1.73 m2.

Comment

Many childhood glomerular diseases, post-streptococcal glomerulonephritis, and steroid-responsive nephrotic syndrome in particular, resolve with no residual signs or symptoms. These data suggest that despite resolution in childhood, some affected individuals will develop hypertension by the age of 40 years. Long-term surveillance of blood pressure following resolution of disease and in adulthood should be recommended.

  • Disclosures for F. Bruder Stapleton, MD at time of publication Consultant / advisory board Navigant Consulting Grant / research support NIH-NICHD; NIH-NCI Editorial boards UpToDate Leadership positions in professional societies American Board of Pediatrics (Chair, Subspecialties Committee); American Pediatric Society (Past President and Council Nominating Chair)

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Reader Comments (1)

FLAVIO PEREZ Medical Student

so interesting in my class

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