Assessing masked hypertension and ambulatory arterial stiffness index in children congenital kidney malformations.

Background: Patients diagnosed with congenital kidney malformations are at an increased risk of developing hypertension, proteinuria, and progressing to chronic kidney disease (CKD). The present study aimed to determine the frequency of masked hypertension and ambulatory arterial stiffness index (AASI) in patients with congenital kidney malformations.

Methods: The study included 174 patients with congenital kidney malformations (48 patients with unilateral renal agenesis (URA), 40 patients with ectopic kidney (EK), 36 patients with horseshoe kidney (HK), 31 patients with multicystic dysplastic kidney (MCDK), 19 patients with unilateral renal hypoplasia (URH), and 45 healthy controls.

Results: The mean age was 12.9 ± 2.9 years, and the male-to-female ratio was 1.5. No significant differences were observed between the congenital kidney malformations groups concerning age, sex, follow-up period, proteinuria, or estimated glomerular filtration rate (eGFR) (P > 0.05). Nevertheless, the prevalence of masked hypertension exhibited a statistically significant increase in the congenital kidney malformations groups (except the URH group) compared to the control group (P < 0.05). The AASI was significantly greater in the congenital kidney malformations groups than in the control group (P < 0.05). The nighttime diastolic blood pressure (DBP), mean arterial pressure (MAP), and DBP index were significantly different between the congenital kidney malformations groups (P < 0.05). However, there were no significant differences in nondipping pattern, proteinuria, or masked hypertension between the congenital kidney malformations groups.

Conclusions: Patients with congenital kidney malformations should be periodically evaluated throughout life for BP. Based on the present findings, we strongly recommend ABPM for the diagnosis of masked hypertension and outcomes, including AASI score.