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Childhood glomerular disease may increase future hypertension risk
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Patients with resolved glomerular disease during childhood were more likely to develop hypertension as adults than those without a history of glomerular disease, researchers reported in a new study.
The cohort study focused on young healthy men treated at the Israel Defense Forces Medical Corps Staff Period Examination Center. Of 38,144 male career personnel included, 264 had resolved glomerular disease during childhood and 37,880 had no history of glomerular disease. All men underwent medical assessment at age 17 years, with follow-up through examination center visits, hypertension diagnosis, retirement from the Israel Defense Forces, or Dec. 31, 2010. Mean follow-up was 18 years.
According to the results, 2,856 patients developed incident hypertension, including 13.6% of those with resolved childhood glomerular disease and 7.4% of those with no history of glomerular disease. The researchers calculated a crude HR of 1.6 (95% CI, 1.15-2.24) and an HR adjusted for age and BMI of 1.67 (95% CI, 1.2-2.31). Exclusion of patients diagnosed with hypertension prior to their initial examination did not significantly alter the association.
Seventy-six percent of patients had available creatinine levels. During follow-up, 2% of patients with resolved childhood glomerular disease had an estimated glomerular filtration rate <60 mL/min/1.73 m2 compared with 1.1% of patients without a history of glomerular disease. Estimated glomerular filtration rate <70 mL/min/1.73 m2 was reported in 13% of patients with a history of glomerular disease compared with 10.4% of those without glomerular disease.
“In this study, resolved childhood glomerular disease was associated with subsequent risk of hypertension in a cohort of young healthy adult men,” the researchers wrote. “… Our results suggest that glomerular disease during childhood may represent a continuum of kidney injury that begins well before sufficient loss of excretory kidney function can be measured with standard laboratory tests, such that the first manifestation may be adult hypertension.”
Disclosure: See the full study for a list of relevant financial disclosures.
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