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Research Article
Association Between Plasma Renin Activity with Hypertension in Children with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Enzyme Deficiency
Siska Mayasari Lubis
Universitas Sumatera Utara Fakultas Kedokteran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5671-7946
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Hypertension is an uncommon manifestation of congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency (21-OHD CAH). Nevertheless, it is necessary to continuously be aware of hypertension incidence in 21-OHD CAH patients and its possible causes. Conflicting results regarding the role of PRA have been reported. This study aims to evaluate the association between plasma renin activity levels (PRA) with hypertension in 21-OHD CAH children.
Methods
We did an observational analytic study with a cross-sectional study design. The subjects were 21-OHD CAH children, aged >6 months to 18 years, selected by consecutive sampling and then compared between 21-OHD CAH with hypertension and non-hypertension groups. We gathered 40 subjects, 20 subjects in hypertension and 20 subjects in non-hypertension groups.
Results
There were 16 from 27 (59.3%) and 4 from 13 subjects (30.8%) with hypertension in salt-wasting and simple virilizing type, respectively. There was a significant mean difference in PRA levels between hypertension and non-hypertension groups in salt wasting patients (p=0,016). The risk of hypertension in salt wasting patients with low PRA levels was 1,09 times after controlling for sex, 17-OHP levels, and the last fludrocortisone dose. The last dose of hydrocortisone had a significant relationship with the incidence of hypertension in salt wasting patients.
Conclusions
This study concludes that hypertension in 21-OHD CAH patients during the study period was 32%. The risk of hypertension in salt wasting patients with low PRA levels was 1.09 times after being controlled for sex, 17 OHP level, and the last dose of fludrocortisone.
Keywords
Congenital adrenal hyperplasia, hypertension, child, hydrocortisone, fludrocortisone
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CURRENT STATUS: Under Review
Version 1
Posted 19 Feb, 2021
No community comments so far
Reviewer #2 agreed
On 15 Feb, 2021
Review #? received
Received 14 Feb, 2021
Reviewer #1 agreed
On 14 Feb, 2021
Reviewers invited
Invitations sent on 13 Feb, 2021
Editor assigned
On 11 Feb, 2021
Submission checks complete
On 11 Feb, 2021
Editor invited
On 11 Feb, 2021
First submitted
On 02 Feb, 2021
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Subject Areas
Pediatrics
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This preprint is under consideration at Italian Journal of Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Association Between Plasma Renin Activity with Hypertension in Children with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Enzyme Deficiency
Siska Mayasari Lubis
Universitas Sumatera Utara Fakultas Kedokteran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5671-7946
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 19 Feb, 2021
No community comments so far
Reviewer #2 agreed
On 15 Feb, 2021
Review #? received
Received 14 Feb, 2021
Reviewer #1 agreed
On 14 Feb, 2021
Reviewers invited
Invitations sent on 13 Feb, 2021
Editor assigned
On 11 Feb, 2021
Submission checks complete
On 11 Feb, 2021
Editor invited
On 11 Feb, 2021
First submitted
On 02 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Hypertension is an uncommon manifestation of congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency (21-OHD CAH). Nevertheless, it is necessary to continuously be aware of hypertension incidence in 21-OHD CAH patients and its possible causes. Conflicting results regarding the role of PRA have been reported. This study aims to evaluate the association between plasma renin activity levels (PRA) with hypertension in 21-OHD CAH children.
Methods
We did an observational analytic study with a cross-sectional study design. The subjects were 21-OHD CAH children, aged >6 months to 18 years, selected by consecutive sampling and then compared between 21-OHD CAH with hypertension and non-hypertension groups. We gathered 40 subjects, 20 subjects in hypertension and 20 subjects in non-hypertension groups.
Results
There were 16 from 27 (59.3%) and 4 from 13 subjects (30.8%) with hypertension in salt-wasting and simple virilizing type, respectively. There was a significant mean difference in PRA levels between hypertension and non-hypertension groups in salt wasting patients (p=0,016). The risk of hypertension in salt wasting patients with low PRA levels was 1,09 times after controlling for sex, 17-OHP levels, and the last fludrocortisone dose. The last dose of hydrocortisone had a significant relationship with the incidence of hypertension in salt wasting patients.
Conclusions
This study concludes that hypertension in 21-OHD CAH patients during the study period was 32%. The risk of hypertension in salt wasting patients with low PRA levels was 1.09 times after being controlled for sex, 17 OHP level, and the last dose of fludrocortisone.