Blood pressure in children with minimal change nephrotic syndrome during oedema and after steroid therapy: the influence of familial essential hypertension.

AIMS: To verify the variations of blood pressure in children with minimal change nephrotic syndrome and to correlate the blood pressure with familial history of essential hypertension.

METHODS

We measured blood pressure in 49 prepubertal nephrotic children, 17 females and 32 males, in the first week of oedema, and after 4 weeks of ISKDC (International Study of Kidney Disease in Children) standard steroid therapy. The children were divided into two groups: one with and the other without familial history of essential hypertension.

RESULTS

Among all the patients, 65% showed systolic and/or diastolic blood pressure higher than the 90th percentile at the first assessment. Among the children with a familial history of essential hypertension, in the oedematous phase of the nephrotic syndrome, 88% showed blood pressure higher than the 90th percentile and no children showed blood pressure lower than the 75th percentile. After therapy, the percentage of children with blood pressure higher than the 90th percentile was 52%. In the group with a negative familial history, at the onset 53% showed blood pressure over the 90th percentile. After 4 weeks of therapy, the percentage of children with blood pressure higher than the 90th percentile was 34%.

CONCLUSIONS

Our study reveals the influence of familial essential hypertension in the oedematous phase of the nephrotic syndrome in children.