Top Tweets for #PedsHTN
Practicing manual BP checks on renal rotation!! Canβt get better than this! Great going @kimmythekidney π #hypertension #pedsHTN @BCM_MedPeds @BCM_Pediatrics
Premature: directly proportional
Birth wt: controversial data. U/ J shaped association
IUGR asso #HTN. early arterial stiffness &endothelial dysfunction
Growth: early rapid wt gain--> increase HTN. But better neurocognitive scores
BF: lower BP
#ASNKids21 #KidneyWk #PedsHTN
Most #NeonatalHTN resolves around 1-2 years
#ASNKids21 #KidneyWk #HTN #PedsHTN #NeonatalHTN
@ASPNeph
Essentially Non-Essential: #SecondaryHypertension Updates
Talk 4/ 4: Neonatal Intensive Care Unit and Beyond: Association of Acquired Early Life Exposures on Cardiovascular Health by Dr.Janis Dionne
#ASNKids21 #KidneyWk #HTN #PedsHTN #NeonatalHTN
@ASPNeph @AspnResearch
Vasopressin and BP
Infusing vasopressin in normotensive do not have much effect
Pts with baroreceptor defects- very sensitive to vasopressin, can develop HTN
not much known in this area
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch
centrally acting adrenergic blockers
S/E: drowsiness, dry mouth, impotence etc
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch
Renal sympathetic may be the Gordian Knot of BP control
Renal denervation via radio ablation is used for refractory HTN
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch
sympathectomy controlled severe HTN - oldest
stimulation of hypothalamus--> BP spike in 1 sec in cats (oldest)
similar studies ~ 20 yrs ago in humans
effects abolished if pituitary & adrenal removed.
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch
HPA axis
about 300 years ago (in 1800s)- neural control of BP was postulated
Hypothalamus-->Sym NS-> adrena medula --> Adrenaline & NA--> flight / flight
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch @ASNKidney
Essentially Non-Essential: Secondary Hypertension Updates
Talk 3/4: Axis or Allies? Impact of the Hypothalamic-Pituitary-Adrenal Axis on BP and Hypertension @joshuaasamuels
#ASNKids21 #KidneyWk #HTN #secondaryHTN #PedsHTN #HPAaxis
@ASPNeph @AspnResearch @ASNKidney
Even if DMSA shows no function, if there is a decent sized kidney on the US, RAS cannulation can be tried and kidney can be salvaged- by Dr. Kjell Tullus
#ASNKids21 #KidneyWk #HTN #PedsHTN #renovascularHTN #SecondaryHTN
@ASPNeph @AspnResearch @ASNKidney
Many RAS is difficult to treat
single RAS is easier to treat
#ASNKids21 #KidneyWk #HTN #PedsHTN #renovascularHTN #SecondaryHTN
@ASPNeph @AspnResearch @ASNKidney
Genetic testing is getting cheaper and better. Use it. On #MonogenicHTN by @jingelfinger
excellent talkπ
@ASPNeph #ASNKids21 @AspnResearch #KidneyWk
#HTN #PedsHTN
Treatment:
Medical-
Surgical-
Multidisciplinary approach beneficial
#ASNKids21 #KidneyWk #HTN #PedsHTN #renovascularHTN #SecondaryHTN
@ASPNeph @AspnResearch @ASNKidney
Takayasu:
widespread disease
sicker
>50% both renal arteries, marked intrarenal disease
25%: mid-aortic syndromes
PET scan helpful
#ASNKids21 #KidneyWk #HTN #PedsHTN #renovascularHTN #SecondaryHTN
@ASPNeph @AspnResearch @ASNKidney
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