Çocukluk çağı primer hipertansiyonuna etki eden faktörlerin araştırılması

Amaç: Primer hipertansiyon erişkin çağındaki kronik böbrek yetmezliği için başlıca risk faktörlerinden biridir. Esansiyel hipertansiyon sebepleri multifaktoriyeldir. Amacımız ambulatuar kan basıncı monitorizasyonu yapılmış primer hipertansiyon saptanan çocuklarda etyolojik faktörleri araştırmaktır. Gereç ve Yöntem: Çalışmaya rutin sağlıklı çocuk kontrollerinde kan basınçları 90 persentilin üzerinde saptanan 56 çocuk ve kan basıncı 90 persentilin altında olan 27 sağlıklı çocuk alındı. Yirmi dört saatlik yaşam içi kan basıncı monitorizasyonu yapılarak gece gündüz kan basıncı ortalamaları, kan basıncı yükleri, dipper-non dipper özellikleri kaydedildi. Plazma renin aktivitesi, serum aldosteron, nitrik oksit, endotelin seviyeleri 24 saatlik idrarda sodyum ve potasyum atılımları karşılaştırıldı. Bulgular: Laboratuvar değerlendirmelerinde hasta grupta kontrol gruba göre plazma renin aktivitesi yüksek, endotelin seviyesi düşük ve idrar sodyum atılımı yüksek saptandı. Sonuç: Çocukluk çağı primer hipertansiyonu ve beyaz önlük hipertansiyonunda plazma renin düzeyinin ve idrar sodyum atılımının önemli rol oynadığı sonucuna varılmıştır.

Investigation of the factors influencing primary hypertension in childhood

Aim: Primary hypertension is the most important risk factor for chronic kidney disease in adulthood. The genesis of essential hypertension is likely to be multifactorial. The aim of this study is to investigate the causing factors of primary hypertension detected by ambulatory blood pressure monitoring in children. Materials and Methods: Fifty-six patients who had blood pressure higher than 90 percentile during the healthy children follow-up and 27 healthy children with the normal blood pressure were included in the study. Twenty-four hour blood pressure measurements with the blood pressure monitor were recorded as the day-night mean blood pressure, the blood pressure loads and the dipper-non-dipper characteristics. Plasma renin levels, serum aldosterone, nitric oxide and endothelin levels and amounts of sodium and potassium excretion in the 24 hour urine and were investigated in all patients and the control group. Results: Laboratory evaluations of the patients showed that the patient group has higher mean levels of plasma renin, lower mean levels of blood endothelin and mean levels of urinary sodium excretion than the control group. Conclusion: In the pathogenesis of childhood primary hypertension and white coat hypertension, which were seen in the half of the children diagnosed as primary hypertension, plasma renin and urinary sodium excretion had important roles.

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Ege Tıp Dergisi-Cover
  • ISSN: 1016-9113
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1962
  • Yayıncı: Ersin HACIOĞLU
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