ABSTRACT
BACKGROUND AND AIMS: The investigation of inflammatory background of hypertension (HTN) concentrates mainly on patients with primary HTN. The aim of the study was to analyze the role of new parameters of inflammation-lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), in the population of children with primary (pHTN) and secondary renal hypertension (rHTN). MATERIAL AND METHODS: The study group consisted of 70 children with pHTN, 46 patients with rHTN, and 30 age-matched normotensive controls. The retrospective analysis focused on the evaluation of LMR, NLR, and PLR values in relation to blood pressure (BP) parameters from in-office and ambulatory BP monitoring measurements. Twenty-four hours, daytime, and nighttime periods were evaluated. Blood pressure variability (BPV) was defined by standard deviation and coefficient of variation of analyzed values. RESULTS: LMR and NLR values in HTN patients differed significantly vs. controls. Dippers with pHTN demonstrated significant correlations between LMR, NLR, PLR, and markers of BPV, in 24 h and daytime diastolic BP and mean arterial pressure. In dippers with rHTN such correlations concerned only LMR. CONCLUSIONS: LMR may become a promising marker of BPV, useful in children with primary and secondary hypertension. IMPACT: Lymphocyte to monocyte ratio is a novel marker of blood pressure variability, connected to target-organ damage, in children with primary and secondary renal hypertension. Our study analyzes for the first time the connections between blood cell count-driven inflammatory markers (lymphocyte to monocyte, neutrophil to lymphocyte, and platelet to lymphocyte ratios) and parameters of blood pressure variability, and compares those ratios in children with primary and secondary hypertension. The increasing incidence of hypertension among children urges the search for simple methods of assessment of its complications. LMR may be of added value in the analysis of the inflammatory background of hypertension.
Subject(s)
Hypertension, Renal , Hypertension , Child , Humans , Pilot Projects , Retrospective Studies , Blood Pressure , Monocytes , Lymphocytes , NeutrophilsABSTRACT
Although anomalies in the urinary tract are the leading cause of chronic kidney disease (CKD) in the pediatric population, there are few studies focusing on etiological discrepancies between younger and older children. AIM: The aim of the study was to perform a comparative analysis of etiology of CKD in children hospitalized in the Department of Pediatric Nephrology at the Wroclaw Medical University, with reference to the patients' age and gender. MATERIALS AND METHODS: The retrospective analysis considered medical records of 174 patients aged 0-18 years, diagnosed with CKD, hospitalized in our Department in the years 2011-2017. The analyzed population was divided regarding the patients' age. Group A contained children up to 2 years of age (45 patients), group B - children aged 2-18 years (129 patients). RESULTS: In younger children, boys prevailed, in older children gender distribution was equal. The most common causative factors of CKD in group A were: urinary tract anomalies (66,7%), perinatal acute kidney injury (17,8%) and hereditary renal disorders (8,9%). In children over 2 years of age, urinary tract anomalies were also the leading cause of CKD (48,8%), followed by glomerulopathies (16,3%) and hereditary renal disorders (15,5%). CONCLUSIONS: Anomalies within the urinary tract are the predominant cause of CKD in children, irrespective of age. Male predominance concerned only children up to 2 years of age. The second causative factor for CKD in the youngest children is acute kidney injury, mainly in the perinatal period. Glomerulopathies and hereditary renal disorders are significant etiological factors for CKD in older children.
