Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series

Alok Kumar, D. Khrime, Utkarsh Sharma
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引用次数: 0

Abstract

Tuberculosis is common in chronic kidney disease (CKD). There are reports of adults with CKD experiencing hypertensive crises and an increase in dosages and number of antihypertensive drugs after starting antitubercular therapy (ATT). Studies have demonstrated that rifampicin could increase the metabolism of beta-blockers, calcium channel blockers, and prazosin. There are no studies or reports of worsening blood pressure (BP) control in children with CKD after starting ATT. Here, we report three cases of children who developed hypertensive crises after starting ATT. All patients presented in emergency with the acute severe rise of BP with breathlessness and or visual blurring. All of them showed retinal changes suggestive of malignant hypertension. They needed parenteral therapy to control BP. They also needed the escalation of antihypertensives and the addition of other drugs. One patient needed a withdrawal of rifampicin. It is suggested that children with CKD should be monitored for BP control after instituting ATT.
慢性肾脏疾病儿童接受抗结核治疗后高血压危象:一个病例系列
结核在慢性肾脏疾病(CKD)中很常见。有报道称,成人慢性肾病患者在开始抗结核治疗(ATT)后出现高血压危象,抗高血压药物的剂量和数量增加。研究表明,利福平可以增加-受体阻滞剂、钙通道阻滞剂和吡嗪的代谢。没有研究或报道CKD儿童在开始ATT后血压(BP)控制恶化。在这里,我们报告了3例儿童在开始ATT后出现高血压危像。所有患者都在急诊时出现急性严重血压升高,伴有呼吸困难和/或视力模糊。所有患者均出现提示恶性高血压的视网膜病变。他们需要肠外治疗来控制血压。他们还需要增加抗高血压药物和其他药物的剂量。一名患者需要停用利福平。建议CKD患儿在实施ATT后应监测血压控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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