Hypertension and albuminuria commonly occur in pediatric patients with type 2 diabetes, a new meta-analysis finds.
Hypertension developed in 25.3% of 3463 patients aged 7 to 20 years with type 2 diabetes in 31 observational studies, M. Constantine Samaan, MD, MSc, of McMaster University in Hamilton, Ontario, Canada, and colleagues reported in JAMA Network Open. Male patients had 42% increased odds of hypertension compared with female patients. By racial category, Pacific Islanders (26.7%) and Indigenous patients (26.5%) had the highest hypertension prevalence followed by White (21.0%), Black (19.0%), Asian (18.4%), and Hispanic (15.1%) patients. Hypertension was most commonly defined as systolic or diastolic blood pressure in the 95th percentile or greater for sex, age, and height.
Albuminuria prevalence was 22.2% among 2250 patients in 14 studies, with no sex differences observed, Dr Samaan’s team reported. Pacific Islanders (31.8%) and Indigenous individuals (24.3%) again had the highest prevalence, followed by Asian (23.0%), Hispanic (23.0%), Black (14.1%), and White patients (12.6%). Albuminuria appeared to worsen with age and duration of diabetes, according to the investigators.
“With adequate glycemic and blood pressure control, the onset of end-stage kidney disease can be delayed, and the risk of microvascular and macrovascular complications can be reduced, making the management of hypertension and albuminuria crucial to improving outcomes in patients with pediatric type 2 diabetes,” according to Dr Samaan’s team.
“There is a critical need for personalized screening and treatment strategies to provide renoprotection from prolonged hyperglycemia and obesity to prevent end-stage kidney disease, future cardiovascular disease, and improve life expectancy.”
Cioana M, Deng J, Hou M, et al. Prevalence of hypertension and albuminuria in pediatric type 2 diabetes: a systematic review and meta-analysis. JAMA Netw Open. Published online April 30, 2021. doi:10.1001/jamanetworkopen.2021.6069