Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

Abstract

An increase in the survival of neonates with antenatal diagnosis of malformations was achieved by the recent technical advances in neonatal intensive care units. The aim of this article is to describe the experience with neonatal arterial hypertension, in newborns with nephro-urological malformations, in a tertiary care referral Nursery, in a period of 4 years. Newborn medical records from the Nursery Annex to the Maternity of Hospital das Clinicas, School of Medicine, University of Sao Paulo, with the diagnosis of nephro-urological malformations and systemic arterial hypertension (SAH) at hospital discharge, in a period from January 1999 to January 2003, were retrospectively analysed. Among 10.278 live newborns in the studied period, 15 (0.15%) newborns were compatible with our inclusion criteria. Of these 15 newborns, 12 (80%) were male and three were premature (20%). In relation to aetiology, 13 (87%) showed urological malformations, 1 (6%) chronic renal insufficiency secondary to kidney dysplasia and one (6%) autosomal recessive polycystic kidney disease. SAH control was achieved with monotherapy in eight patients (53%), five patients (33%) needed an association of two drugs (calcium-channel blocker and angiotensin converting enzyme (ACE) inhibitor), one child used three types of antihypertensive drugs (calcium-channel blocker, ACE inhibitor and hydrochlorothiazide) for pressoric control and one child's blood pressure (BP) was controlled exclusively by peritoneal dialysis. The incidence of nephro-urological malformations in our service during the studied period was 0.89%. SAH incidence among these newborns was 19%. Our data reinforce previous studies pointing to the necessity to consider children with nephro-urological malformations as a risk group for SAH, who should have the BP evaluated since the neonatal period.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Flynn JT . Neonatal hypertension: diagnosis and management. Pediatr Nephrol 2000; 14: 332–341.

    Article  CAS  Google Scholar 

  2. Guignard JP, Gouyon JB, Adelman RD . Arterial hypertension in the newborn infant. Biol Neonate 1989; 55: 77–83.

    Article  CAS  Google Scholar 

  3. Zubrow AB, Hulman S, Kushner H, Falkner B . Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study. J Perinatol 1995; 15: 470–479.

    CAS  Google Scholar 

  4. Report of the second task force on blood pressure control in children. Pediatrics 1987; 79: 1–25.

  5. Matsuoka OT, Pinheiro AC, Pascuas DZP, Leone CR . Evolução dos niveis de pressão arterial sistemica no período neonatal em. RNT-AIG J Ped (Rio J) 1996; 72: 155–158.

    Article  CAS  Google Scholar 

  6. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R . New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991; 119: 417–423.

    Article  CAS  Google Scholar 

  7. Troele DG, Muster AJ, Paul MH . Recognition of coarctation of the aorta. Am J Dis Child 1987; 141: 1201–1204.

    Article  Google Scholar 

  8. Strafford MA, Griffiths SP, Gersony NM . Coarctation of the aorta: a study in delayed detection. Pediatrics 1982; 69: 159–163.

    CAS  PubMed  Google Scholar 

  9. Watkinson M . Hypertension in the newborn baby. Arch Dis Child Fetal Neonatal Ed 2002; 86: F78–F81.

    Article  CAS  Google Scholar 

  10. Kilian K . Hypertension in neonates: causes and treatments. J Perinat Neonat Nurs 2003; 17: 65–74.

    Article  Google Scholar 

  11. Skalina ME, Kliegman RM, Fanaroff AA . Epidemiology and management of severe symptomatic neonatal hypertension. Am J Perinatol 1986; 3: 235–239.

    Article  CAS  Google Scholar 

  12. Buchi KF, Siegler RL . Hypertension in the first month of life. J Hypertens 1986; 4: 525–528.

    Article  CAS  Google Scholar 

  13. Singh HP, Hurley RM, Myers TF . Neonatal hypertension: incidence and risk factors. Am J Hypertens 1992; 5: 51–55.

    Article  CAS  Google Scholar 

  14. Finney H, Newman DJ, Thakkar H, Fell JME, Price CP . Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. 2000; 82: 71–76.

  15. Mitsnefes M, Ho PL, McEnery PT . Hypertension and progression of chronic renal insufficiency in children: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). J Am Soc Nephrol 2003; 14: 2618–2622.

    Article  Google Scholar 

  16. Josephson S, Lannergren K, Eklof AC . Partial ureteric obstruction in weanling rats. II. Long-term effects on renal function and arterial blood pressure. Urol Int 1992; 48: 384–390.

    Article  CAS  Google Scholar 

  17. Langbaum M, Eyal FG . A practical and reliable method of measuring blood pressure in the neonate by pulse oximetry. J Pediatr 1994; 125: 591–595.

    Article  CAS  Google Scholar 

  18. Northern Neonatal Nursing Initiative. Systolic blood pressure in babies less than 32 weeks gestation in the first year of life. Arch Dis Child Fetal Neonatal Ed 1999; 80: F38–F42.

  19. Cunningham S, Symon AG, Elton RA, Zhu C, McIntosh N . Intra-arterial blood pressure reference ranges, death and morbidity in very low birthweight infants during the first seven days of life. Early Hum Dev 1999; 56: 151–165.

    Article  CAS  Google Scholar 

  20. British Hypertension Society automatic digital blood pressure devices for clinical use. At http://www.bhsoc.org/bp_monitors/automatic_clinic.htm.Last Access on April 8, 2006.

  21. Colan SD, Fujii A, Borow KM, MacPherson D, Sanders SP . Noninvasive determination of systolic, diastolic and end-systolic blood pressure in neonates, infants and young children: comparison with central aortic pressure measurements. Am J Cardiol 1983; 52: 867–870.

    Article  CAS  Google Scholar 

  22. Park MK, Lee DH . Normative arm and calf blood pressure values in the newborn. Pediatrics 1989; 83(2): 240–243.

    CAS  PubMed  Google Scholar 

  23. Hulman S, Edwards R, Chen YQ, Falkner B . Blood pressure patterns in the first three days of life. J Perinatol 1991; 11: 231–234.

    CAS  PubMed  Google Scholar 

  24. Hagyi T, Anwar M, Carbone MT, Ostfeld B, Hiatt M, Koons A et al. Blood pressure ranges in premature infants. II The first week of life (1996). Pediatrics 1996; 97: 336–342.

    Google Scholar 

  25. National high blood pressure education program working group on high blood pressure in children and adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 11(2 Suppl): 555–576.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to V H Koch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lanzarini, V., Furusawa, E., Sadeck, L. et al. Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital. J Hum Hypertens 20, 679–683 (2006). https://doi.org/10.1038/sj.jhh.1002051

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002051

Keywords

This article is cited by

Search

Quick links