Resumen

MURIGO-SHUMBA, D; BHIMMA, R  y  NAICKER, E. Severe hypertension in children at a central referral hospital in KwaZulu-Natal Province, South Africa. S. Afr. j. child health [online]. 2019, vol.13, n.1, pp.44-48. ISSN 1999-7671.  http://dx.doi.org/10.7196/sajch.2019.v13i1.1564.

BACKGROUND: Hypertension (HPT) is often underdiagnosed in children, although significant morbidity and mortality arises from hypertensive target organ damage and hypertensive crises OBJECTIVES: To determine the prevalence, complications and causes of severe HPT in children <12 years old at a central hospital METHODS: Hospital records of children < 12 years old with severe HPT (stage 2 and higher) from 2005 to 2014 were reviewed. Demographics, nutritional status, causes, HIV status, presence of target organ damage and treatment were analysed RESULTS: Of 821 children admitted to the paediatric nephrology unit, 152 (18.5%) children had severe HPT, with a mean age of 6.3 years; 86 (57%) were boys. A total of 28 (19%) were HIV-positive, and 19 (68%) were treatment naive. Kidney disease accounted for 82% of cases, 46 (30%) having steroid-resistant nephrotic syndrome, 22 (14%) HIV-associated nephropathy, 19 (13%) glomerulonephritis, 21 (14%) congenital urinary tract abnormalities and 17 (11%) other renal causes. Renovascular causes accounted for 12 (8%) cases. Of these 12,7 (58%) had left ventricular hypertrophy (LVH), compared with 10/125 (8%) who had other forms of kidney disease (jkO.023). Hypertensive crises occurred in 28 (18%) patients, and were significantly more common in children with HPT secondary to renovascular causes than renal causes (p=0.001 CONCLUSION: Renal diseases were the most common cause of severe HPT in children. Hypertensive crises, retinopathy and LVH are common in renovascular HPT

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