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Twenty-four-hour ambulatory blood pressure in adult women with urinary tract infection in childhood

Gebäck, Carina,b; Hansson, Sverkera; Himmelmann, Andersc; Sandberg, Torstenb; Sixt, Runed; Jodal, Ulfa

doi: 10.1097/HJH.0000000000000234
ORIGINAL PAPERS: Kidney

Objective: To study 24-h ambulatory blood pressure (BP) and development of hypertension over four decades in women with childhood urinary tract infection (UTI) associated with renal damage.

Methods: A population-based group of 111 women was followed from their first UTI in childhood. The cohort was investigated at a median age of 27 years using standardized office BP measurement and was reinvestigated 15 years later with 24-h ambulatory BP monitoring (ABPM) and 99mTc-dimercaptosuccinic acid scan for evaluation of renal damage.

Results: Eighty-six women with median age 41 years completed the reinvestigation. Hypertension occurred in 26 women, four of 28 (14%) without and 22 of 58 (38%) with renal damage (P = 0.04). The hypertension was diagnosed before entry in seven and in the study by ABPM in another 19 women. In 78 women, of which 50 had renal damage, the ABPMs were correlated to renal damage. There was significant difference between the groups without and with renal damage when mean 24-h systolic, mean daytime systolic and mean night-time SBP were compared (P = 0.03, P = 0.04, P = 0.01, respectively). The results remained significant when the group with damage was divided into subgroups with increasing extent of damage: class 1, 2 and 3 (P = 0.01, P = 0.02, P = 0.008, respectively).

Conclusion: Women with UTI-associated renal damage but well preserved function had significantly higher 24-h ambulatory BP and more often hypertension than comparable women without damage. This shows that women with UTI-associated renal damage are at increased risk of hypertension and should be considered for regular BP screening, preferably with 24-h ABPM.

aDepartment of Pediatrics, The Queen Silvia Children's Hospital

bDepartment of Infectious Diseases, Sahlgrenska University Hospital

cDepartment of Medicine, Sahlgrenska University Hospital

dDepartment of Pediatric Clinical Physiology, The Queen Silvia Children's Hospital

Sahlgrenska Academy, University of Gothenburg, Göteborg

Correspondence to Carin Gebäck, Bacteriological Laboratory, Sahlgrenska University Hospital, SE-402 34 Göteborg, Sweden. Tel: +46 31 342 4994; fax: +46 31 342 4901; e-mail: carin.geback@vgregion.se

Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; CKD, chronic kidney disease; DMSA, 99mTc-dimercaptosuccinic acid; eGFR, estimated glomerular filtration rate; UTI, urinary tract infection

Received 27 April, 2013

Revised 31 March, 2014

Accepted 31 March, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins