Investigating the relationship between serum uric acid level and the extent and severity of target organ damage in children and adolescents with hypertension

Abstract

More accurate assessment and early diagnosis of cardiac, neurological, and visual complications of children with high blood pressure can be effective in reducing mortality and morbidity, and the financial burden imposed on the health and treatment system of society and the families of these patients. In addition, until today, no study in this field to this extent has been registered in the East Azerbaijan region and Tabriz University. This study aims to investigate the relationship between serum uric acid levels and the extent and severity of target organ damage in children and adolescents with hypertension. Materials and Methods: In this cross-sectional and analytical study, children aged one month to 18 years who have hypertension were included. First, the medical records of the patients who have been diagnosed with hypertension in the last 5 years at the Mardani-Azari Children's Hospital were extracted and then, the patients were called by phone to check the possible damage to the organs in question and further investigations if they wish to go to the hospital. Investigations included clinical symptoms, paraclinical evaluations such as biochemical tests, measurement of uric acid serum level, hormone, urinalysis, ultrasound, echocardiography, and imaging evaluations of kidney, adrenal gland, thyroid, and parathyroid. Blood pressure, presence and severity of target organ damage such as cardiovascular system, nervous system, visual system and other associated risk factors such as diabetes, and hyperlipidemia were evaluated in all patients. Results: In this cross-sectional study, 50 children with hypertension with an average age of 10.5 years, 72% of whom were boys, were examined. In terms of the history of underlying diseases, only the history of seizures in patients with TOD was significantly higher than in patients without TOD (27.8% vs. 0%; p=0.027). The frequency of TOD was 72%, where 11 patients (22%) had one case of TOD, 9 patients (18%) had two cases of TOD, 13 patients (26%) had three cases of TOD, and 3 patients (6%) had four cases of TOD. The average diastolic blood pressure of patients with TOD was higher than that of patients without TOD (MD=11.4 mmHg; p=0.004). Serum uric acid levels in children with primary hypertension had a direct and significant correlation with systolic blood pressure (r=0.286, p=0.044) and diastolic blood pressure (r=0.289, p=0.042). Serum uric acid levels higher than or equal to 4.6 mg/dl with 80.6% sensitivity and 42.9% specificity can predict TOD in patients.