输尿管盆腔交界处梗阻导致的严重肾积水对小儿血压的潜在影响。

IF 2 3区 医学 Q2 PEDIATRICS
Qingqing Tian, Chu Zhang, Xiang Zhao, Kechi Yu, Erhu Fang, Xuefeng Zhou, Yonghua Niu, Ning Li
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引用次数: 0

摘要

背景:根据已发表的病例报告和动物实验,肾积水可能会影响血压(BP)。由于儿童本身血压较低,血管弹性较好,对高血压的抵抗力强于成人,因此对儿童血压的影响常常被忽视:本研究旨在前瞻性地观察继发于输尿管肾盂连接处梗阻(UPJO)的肾积水对小儿血压的影响:方法:将需要进行肾盂成形术的UPJO继发性肾积水患儿分为五个年龄组:新生儿、婴儿、幼儿、学龄前儿童和学龄儿童。对这些年龄组的术前和术后收缩压(SBP)、舒张压(DBP)、活性肾素浓度(ARC)和醛固酮浓度(AC)进行比较,然后与没有肾炎或心血管疾病的对照组儿童进行比较。研究还探讨了继发于 UPJO 的严重肾积水对小儿血压的影响及其与肾素-血管紧张素-醛固酮系统(RAAS)的关系:这项研究在 2021 年 9 月至 2023 年 6 月期间招募了 114 名继发于 UPJO 的严重肾积水儿童和 153 名无肾炎或心血管疾病的儿童。随着对照组年龄的增长,SBP 和 DBP 上升,而 ARC 和 AC 下降。总体而言,肾积水组的 SBP、DBP、ARC 和 AC 均高于对照组。这些差异在不同年龄组之间存在差异。肾盂成形术后,肾积水组的术后血压接近对照组。术后 ARC 水平高于对照组,但远低于术前水平。术后 AC 没有明显下降。肾盂成形术前后肾积水患儿的 DBP 变化与 AC 变化呈正相关:结论:继发于 UPJO 的严重肾积水儿童患者的血压、ARC 和 AC 均升高。肾盂成形术后,这些患者的血压有所下降。血压升高与 RAAS 之间的相关性需要进一步全面研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Potential impact of severe hydronephrosis secondary to ureteropelvic junction obstruction on pediatric blood pressure.

Background: Hydronephrosis could affect blood pressure (BP) according to published case reports and animal experiments. The impact on pediatric BP is often overlooked due to children's inherently lower BP, superior vascular elasticity and greater resistance to hypertension than adults.

Objective: This study aimed to prospectively observe the effects of hydronephrosis, secondary to ureteropelvic junction obstruction (UPJO), on pediatric BP.

Methods: Children with hydronephrosis secondary to UPJO who required pyeloplasty were categorized into five age groups: neonates, infants, toddlers, preschoolers, and school-aged children. Preoperative and postoperative systolic blood pressure (SBP), diastolic blood pressure (DBP), active renin concentration (ARC), and aldosterone concentration (AC) were compared among these age groups, followed by comparison with a control group of children without nephritis or cardiovascular conditions. The impact of severe hydronephrosis secondary to UPJO on pediatric BP and its association with the renin-angiotensin-aldosterone system (RAAS) were examined.

Results: This study enrolled 114 children with severe hydronephrosis secondary to UPJO and 153 without nephritic or cardiovascular conditions between September 2021 and June 2023. As the control group aged, SBP and DBP increased, whereas ARC and AC decreased. Overall, hydronephrosis group had higher SBP, DBP, ARC, and AC than the controls group. These differences differed between the age groups. After pyeloplasty, the postoperative BP of hydronephrosis group approximated that of the control group. Postoperative ARC levels were higher than those in the control group but were much lower than the preoperative levels. AC did not decrease significantly after surgery. The change in DBP in children with hydronephrosis before and after pyeloplasty showed a positive correlation with the change in AC.

Conclusions: Pediatric patients with severe hydronephrosis, a condition secondary to UPJO, displayed elevated BP, ARC, and AC. Following pyeloplasty, these patients noted a reduction in BP. The correlation between elevated blood pressure and the RAAS necessitates further comprehensive investigation.

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来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
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