Effect of arterial hypertension on renal lesions in children with type 1 diabetes
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Klinika Kardiologii i Nefrologii Dziecięcej, Szpital Kliniczny Uniwersytetu Medycznego w Poznaniu
Klinika Diabetologii i Otyłości Wieku Rozwojowego, Szpital Kliniczny Uniwersytetu Medycznego w Poznaniu
Jolanta Sołtysiak
Klinika Kardiologii i Nefrologii, Szpital Kliniczny im. K. Jonschera Uniwersytetu Medycznego w Poznaniu, ul. Szpitalna 27/33, 60-572 Poznań
Med Og Nauk Zdr. 2013;19(1):55–58
Arterial hypertension (AH), one of the complications of type 1 diabetes (T1DM) is a risk factor of the development of diabetic nephropathy. Evaluation of arterial hypertension in children with T1DM based on 24-hour monitoring (ABPM), and the relationship between ABPM parameters and albuminuria (ACR) and risk factors of diabetic nephropathy, i.e. glycosylated hemoglobin (HbA1c), duration of diabetes, total cholesterol (Chol), and triglycerides (TG).

Material and Methods:
The study covered 107 children (53 girls and 54 boys) with T1DM; mean age 14.22±2.90; mean duration of the disease T1DM 5.81±3.62 years. The measurements were performed by ABPM using the oscillometric method. The values of the systolic blood pressure were analysed during the day (SBPD) and at night (SBPN), diastolic pressure during the day (DBPD) and night (DBPN), and night decrease of the arterial pressure. AH was diagnosed in more than 95% of patients, prehypertension (preAH) – in more than 90%, and normal blood pressure (nBP) in less than 90%

AH was observed in 25.3% of children, preHA – in 22.4%, and nBP – in 52.3%. Children with AH were significantly older statistically, compared to those with nBP, with longer duration of the disease and higher BMI, HbA1c, ACR and TG values. A positive relationship was observed between arterial hypertension and duration of T1DM, BMI, ACR and TG. A lack of night decrease of the arterial pressure was found in 34% of children. These children, compared to patients with maintained daily pressure profile, did not differ with respect to the BMI, HbA1c, ACR, Chol and TG.

Arterial hypertension more frequently occurs in children with T1DM, compared to the total populaiton. The risk of renal lesions in T1DM significantly increases in children with AH, and is related with the value of arterial blood pressure.

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