Blood Pressure Changes during Initial and Relapsing Episodes in Children with Nephrotic Syndrome: A Comparative Study

Abstract

Hypertension is an important feature arising from altered homeostasis related to the disease process in nephrotic syndrome. It indicates the disease state and response to therapy as well as dictates the treatment plan.The present study aims to detect changes in diastolic and systolic blood pressure during the initial and relapsing episode of nephrotic syndrome and compare them for future guidance in therapy.This observational, cross-sectional study was conducted between October 2016 and January 2019 with patients attending the pediatric clinic with either initial episode or relapse of nephrotic syndrome. A total of 100 patients with 50 patients in each group were included. The blood pressure was recorded and blood, and urine samplesof each subject analyzed.The present study indicates that though the majority of the patients in both the groups have normal systolic and diastolic pressure, diastolic blood pressure was significantly high in the relapse group. There was alsoa significant reduction in serum albumin and spot protein creatinine ratio in the relapse group.Blood pressure measurement needs to be part of the routine examination of any child attending a nephrology consultation clinic or admitted to the hospital. Children who developed hypertension during treatment or relapse indicate that nephrotic syndrome should be followed up over a long duration. Altered blood pressure may necessitate encouragement for regular follow up in nephrology clinic for early recognition and treatment of long term complications.