Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 8, November, p. 1263–1268

doi: 10.17219/acem/65823

Publication type: original article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Antihypertensive treatment prescription in pediatric dialysis patients in Poland: A comparison between two nationwide studies 2003/2004–2013

Krzysztof Wróblewski1,A,B,C,D,E,F, Karolina Hincz2,B, Monika Miklaszewska3,B, Katarzyna Zachwieja3,B, Ryszard Wierciński4,B, Roman Stankiewicz5,B, Agnieszka Firszt-Adamczyk5,B, Jacek Zachwieja6,B, Halina Borzęcka7,B, Helena Ziółkowska8,B, Anna Medyńska9,B, Danuta Zwolińska9,B, Maria Szczepańska10,B, Małgorzata Stańczyk11,B,C, Ilona Zagożdżon12,B, Beata Leszczyńska8,B, Piotr Adamczyk10,B, Marcin Tkaczyk11,13,A,B,E,F

1 Department of Internal Medicine and Nephrodiabetology, Medical University of Lodz, Poland

2 Department of Gynecology and Perinatology, Polish Mothers Memorial Hospital Research Institute, Poland

3 Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland

4 Department of Pediatrics and Nephrology, Medical University of Bialystok, Poland

5 Department of Pediatric Nephrology, Regional Hospital, Toruń, Poland

6 Department of Cardiology and Nephrology, Poznan University of Medical Sciences, Poland

7 Department of Pediatric Nephrology, Medical University of Lublin, Poland

8 Chair and Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland

9 Department of Pediatric Nephrology, Wroclaw Medical University, Poland

10 Department of Nephrology and Dialysis, Medical University of Silesia, Zabrze, Poland

11 Department of Pediatrics, Immunology and Nephrology, Polish Mothers Memorial Hospital Research Institute, Poland

12 Department of Child and Adolescents’ Nephrology and Hypertension, Medical University of Gdańsk, Poland

13 Division of Didactics in Pediatrics, Medical University of Lodz, Poland

Abstract

Background. Blood pressure in pediatric dialyzed patients is under poor control.
Objectives. The aim of the study was to assess the strategy and efficacy of antihypertensive drugs used for the treatment of hypertension in pediatric dialyzed patients in 2013 in comparison with the data collected in 2003/2004. The results have been viewed against present strategies of antihypertensive treatment in children. There is still limited data concerning the treatment of hypertension in dialyzed pediatric patients.
Material and Methods. The study embraced 10 of 12 pediatric dialysis units in Poland treating 59 pediatric patients (mean age – 132 months). Collected information included present antihypertensive treatment with regard to drug classes and the dose of antihypertensive agent. The treatment was regarded as effective if both systolic and diastolic values of blood pressure were below 1.64 SDS. The results from 2013 were juxtaposed with previously analyzed data from a similar study on hypertension in dialyzed children conducted in 2003/2004.
Results. Forty subjects have been provided with antihypertensive treatment. In monotherapy and polytherapy 50% of the subjects were treated with ACEI (enalapril and ramipril), 67.5% with amlodipine, 50% with beta-blockers. Only 10% of the subjects were treated with angiotensin II receptor blocker (losartan). Thirty percent of the subjects received furosemide, whereas 5% were given doxazosin. Antihypertensive drugs regarded as the 2nd and 3rd choice in treating high blood pressure (doxazosin, beta-blockers and furosemide) were applied as monotherapy in 46% of the patients. Satisfactory control of treated blood pressure was reached in 45% of them.
Conclusion. Antihypertensive treatment in dialyzed children did not change significantly during the last decade with regard to the groups of drugs being used. Despite a wider feasibility of antihypertensive substances, the effectiveness of this therapy was still unsatisfactory.

Key words

children, treatment, arterial hypertension, dialysis

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