ArticlePediatric research2021
Proteinuria and nocturnal blood pressure dipping in hypertensive children and adolescents.
Article in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Masked hypertension and non-dipping blood pressure profiles in pediatric survivors of acute kidney injury: a systematic review and meta-analysis.Journal of human hypertension · 2026Pooled it
- Non-Dipping Blood Pressure in Pediatric Hypertension: A Narrative Review.Reviews in cardiovascular medicine · 2026Review
- Non-Dipping Blood Pressure and Reduced Heart Rate Deceleration Capacities Are Associated With Malnutrition in Patients With Gastrointestinal Cancer.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Sex difference in nocturnal blood pressure dipping in adolescents with varying degrees of adiposity.BMC pediatrics · 2024Article
- Hypertension in Wilms tumor.Pediatric nephrology (Berlin, Germany) · 2024Review
- Nocturnal Dipping and Kidney Function Decline: Findings From the CKD in Children Study.Kidney international reports · 2022Article
- Circadian Blood Pressure Profile in Pediatric Patients with Primary Hypertension.Journal of clinical medicine · 2022Article
- Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort.Clinical journal of the American Society of Nephrology : CJASN · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe absence of nocturnal blood pressure dipping is associated with adverse cardiovascular outcomes in adults, and proteinuria is a risk factor for non-dipping in this population. Risk factors for non-dipping in children are largely unknown.
methodsWe retrospectively identified patients aged 5-19 years who underwent 24-h ambulatory blood pressure monitoring (ABPM) from August 2018 to January 2019 and had a spot urine protein-to-creatinine ratio (PCR) within 1 year of their ABPM. Dipping was defined as ≥10% reduction in systolic and diastolic blood pressure from day to night. Multivariable logistic and linear regression models evaluated the association of proteinuria with non-dipping.
resultsAmong 77 children identified, 27 (35.1%) were non-dippers. Each two-fold higher urine PCR was associated with 38% higher odds of non-dipping, after adjusting for body mass index (BMI). Higher urine PCR was also associated with a lower diastolic dipping percentage by 1.33 (95% confidence interval 0.31-2.34), after adjusting for BMI, age, and estimated glomerular filtration rate.
conclusionsLimitations of this study include its retrospective design and the time lapse between urine PCR and ABPM. Proteinuria appears to be associated with blood pressure non-dipping in children. This finding needs to be confirmed in prospective studies. IMPACT: Our study demonstrates the association of proteinuria with non-dipping of blood pressure in children. This association has been explored in adults, but to our knowledge, this is the first time it is evaluated in children referred for evaluation of elevated blood pressure. Non-dipping is a modifiable risk factor for kidney function decline and cardiovascular disease in adulthood, and thus early identification in children is important. The association between proteinuria and non-dipping in children will allow us to more readily identify those at risk, with a future focus on interventions to modify blood pressure dipping patterns.
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