Approaches of pediatric nephrologists to hypertensive patients in Turkey (Turkish pediatric hypertension working group study)

Abstract

Objective: We aimed to evaluate the approaches of pediatric nephrologists in our country to the management of childhood hypertension. Methods: The pediatric nephrologists in our country were invited to fill out an online questionnaire including 24 questions. The answers were compared between those working in the field for <= 10 years (Group 1, n =74) and >10 years (Group 2, n = 62). Results: of 136 participants (M/F = 101/35), 52% were following a single guideline [31% Fourth Report of 2004, 17% European Society of Hypertension in 2016, and 52% American Academy of Pediatrics in 2017], which is more common in Group 1 (P =.035). The most commonly used guideline was American Academy of Pediatrics of 2017 and Group 2 used Fourth Report of 2004 more commonly (P =.042). The most common choice to diagnose hypertension was office + home + ambulatory blood pressure monitoring (59%). The frequency of screening for end-organ damage at first evaluation was 96%. The time to wait for the effect of lifestyle modifications was 3 months in 52%. The first choice medication was angiotensin-converting enzyme inhibitors (49%) or calcium-channel blockers (48%) in non-obese and angiotensin-converting enzyme inhibitors (74%) in obese children. Calcium-channel blockers were more commonly prescribed as the first choice in non-obese children in Group 1 (P =.035). The most accessible emergency drug was esmolol. Conclusion: Despite following recent guidelines, the time spent in the proficiency would change the practices.