OBJECTIVEFrom the end of 1990s, ambulatory blood pressure monitoring (ABPM), which measures ambulatory blood pressure (ABP) during a whole 24 hours, has been applied. However, there are few studies on the use of ABPM in children with kidney disease, especially those whose renal function is normal or mildly impaired in both China and abroad. This study aimed to explore the characteristics of ABP in patients with common pediatric kidney diseases.

METHODSTotally 33 patients (21 boys and 12 girls) hospitalized in our hospital with kidney diseases aged from 5 - 16 yrs from February 2005 to January 2006 were enrolled; 28 cases (85%) had normal renal function [Ccr > or = 90 mmol/(Lx1.73 m2)]. None of them were taking anti-hypertensive drugs during the monitoring. Twenty-four-hour ABP monitoring was performed by using Welch Allyn ABPM 6100 in the patients. ABPM recordings of 1141 healthy children performed in Germany in 1997 was used as the normal reference data, which was the largest pediatric study and was most commonly used in the world up to now.

RESULTSThe incidence of nocturnal hypertension was significantly higher than that of diurnal hypertension (P < 0.01); nocturnal systolic/diastolic blood pressure load (29.1 +/- 34.5)%/(24.9 +/- 34.3)% and index (0.95 +/- 0.11)/(0.90 +/- 0.18) were significantly higher than diurnal systolic/diastolic blood pressure load (12.9 +/- 23.6%/9.3 +/- 19.1%) and index (0.88 +/- 0.09)/(0.77 +/- 0.12) (P < 0.01); nocturnal systolic/diastolic dipping rate (7.3 +/- 5.3)%/(10.5 +/- 10.6)% in the patients was significantly lower than that in the healthy children (13 +/- 6)%/(23 +/- 9)% (P < 0.01); the incidence of non-dipper in 33 patients was 72.7%, even with the same incidence in patients with normal blood pressure. Five cases had elevated CBP whose ABP were also elevated; while among the 28 cases with normal CBP, 6 cases were found to have elevated ABP.

CONCLUSIONSABPM can detect the nocturnal hypertension and abnormal rhythm of blood pressure during 24-hour in patients with pediatric nephropathy. ABPM can also disclose masked hypertension, thereby warrant to follow-up and start earlier intervention.

Adolescent ; Blood Pressure ; physiology ; Blood Pressure Monitoring, Ambulatory ; Case-Control Studies ; Child ; Child, Preschool ; Circadian Rhythm ; physiology ; Female ; Humans ; Hypertension ; diagnosis ; physiopathology ; Kidney Diseases ; physiopathology ; Male

OBJECTIVETo study the value of apolipoprotein H (apoH) gene expression in peripheral blood mononuclear cell (PBMC) and urinary N-Acetyl-beta-D-Glucosaminidase (NAG) and retinal-binding protein (RBP) in the early diagnosis of renal function damage in neonates.

METHODSSixty sick neonates who renal function damage probably occurred were enrolled. The blood and urinary samples were collected twice within 48 hrs following admission, with an interval of 12-24 hrs. Expression of apoH gene in PBMC was determined with RT-PCR. The levels of blood urea nitrogen (BUN) and creatinine, and urinary activities of NAG and RBP were measured with enzymatic reaction.

RESULTSThe abnormal rates of blood apoH and urinary NAG and RBP were 73.3%, 83.3% and 76.7%, respectively in the first detection. The second detection for blood apoH and urinary NAG and RBP showed abnormal rates of 70.0%, 66.7% and 76.7%, respectively. There were no significant differences in the abnormal rates between the three markers either in the first or the second detection (P>0.05). Beside there were no significant significances in the abnormal rates between urinary NAG and blood BUN in the second detection, the abnormal rates of blood apoH and urinary NAG and RBP in both detections were significantly higher than those of BUN or creatinine (P<0.01 or 0.05).

CONCLUSIONSThere are identical values of blood apoH gene expression and urinary NAG and RBP in the early diagnosis of renal function damage in neonates. The above three markers are more sensitive to early renal function damage than blood BUN and creatinine.

Acetylglucosaminidase ; urine ; Blood Urea Nitrogen ; Creatinine ; blood ; Female ; Humans ; Infant, Newborn ; Kidney Diseases ; diagnosis ; physiopathology ; Male ; Retinol-Binding Proteins ; urine ; beta 2-Glycoprotein I ; blood ; genetics

BACKGROUND/AIMS: We analyzed chronological changes in hemoglobin according to renal function changes over a 5-year follow-up period. METHODS: We enrolled 5,266 adults with a glomerular filtration rate (GFR) > or = 60 mL/min/1.73 m2 at an initial examination at a routine health check-up; a follow-up examination was conducted 5 years later. We categorized the subjects according to GFR ratio (groups 1, 2, and 3, defined as GFRratio > or = 1.00, 0.75 to 0.99, and < 0.75, respectively). RESULTS: The mean hemoglobin level in subjects with a GFR of 60 to 74 was higher than in those with a GFR of 75 to 89 or > or = 90 mL/min/1.73 m2 at the initial examination (all p < 0.001). Among females and males, the frequencies of increased hemoglobin were 46.8% and 40.6% in the GFRratio group 1, 52.4% and 46.1% in group 2, and 59.6% and 52.5% in group 3 over the 5-year period, respectively (all p < 0.001). With multiple logistic regression, group 3 showed 1.594-fold (95% confidence interval [CI], 1.127 to 2.225) and 1.353-fold (95% CI, 1.000 to 1.830) higher likelihoods of increased hemoglobin over the 5-year follow-up period in females and males, respectively. The estimated difference in hemoglobin level was highest in group 3 in both genders. These findings were more evident in subgroups without metabolic syndrome, diabetes mellitus, hypertension, or GFR less than 90 mL/min/1.73 m2. CONCLUSIONS: Among a population with GFR > or = 60 mL/min/1.73 m2, a mild decrease in GFR over a 5-year follow-up period was associated with an increase in hemoglobin levels.
Adult ; Aged ; Biological Markers/blood ; Chi-Square Distribution ; Disease Progression ; Female ; Follow-Up Studies ; *Glomerular Filtration Rate ; Hemoglobins/*metabolism ; Humans ; Kidney/*physiopathology ; Kidney Diseases/blood/diagnosis/*physiopathology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Republic of Korea ; Time Factors ; Up-Regulation