Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series

Tuberculosis is common in chronic kidney disease (CKD). There are reports of adults with CKD experiencing hypertensive crises and an increase in dosages and number of antihypertensive drugs after starting antitubercular therapy (ATT). Studies have demonstrated that rifampicin could increase the meta...

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Main Authors: Alok Kumar, Dorchhom Khrime, Utkarsh Sharma
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=6;spage=213;epage=215;aulast=Kumar
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author Alok Kumar
Dorchhom Khrime
Utkarsh Sharma
author_facet Alok Kumar
Dorchhom Khrime
Utkarsh Sharma
author_sort Alok Kumar
collection DOAJ
description Tuberculosis is common in chronic kidney disease (CKD). There are reports of adults with CKD experiencing hypertensive crises and an increase in dosages and number of antihypertensive drugs after starting antitubercular therapy (ATT). Studies have demonstrated that rifampicin could increase the metabolism of beta-blockers, calcium channel blockers, and prazosin. There are no studies or reports of worsening blood pressure (BP) control in children with CKD after starting ATT. Here, we report three cases of children who developed hypertensive crises after starting ATT. All patients presented in emergency with the acute severe rise of BP with breathlessness and or visual blurring. All of them showed retinal changes suggestive of malignant hypertension. They needed parenteral therapy to control BP. They also needed the escalation of antihypertensives and the addition of other drugs. One patient needed a withdrawal of rifampicin. It is suggested that children with CKD should be monitored for BP control after instituting ATT.
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spelling doaj.art-04a39ea3a32046bc9b9d825ada02ecff2022-12-22T04:23:00ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992022-01-019621321510.4103/jpcc.jpcc_64_22Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case seriesAlok KumarDorchhom KhrimeUtkarsh SharmaTuberculosis is common in chronic kidney disease (CKD). There are reports of adults with CKD experiencing hypertensive crises and an increase in dosages and number of antihypertensive drugs after starting antitubercular therapy (ATT). Studies have demonstrated that rifampicin could increase the metabolism of beta-blockers, calcium channel blockers, and prazosin. There are no studies or reports of worsening blood pressure (BP) control in children with CKD after starting ATT. Here, we report three cases of children who developed hypertensive crises after starting ATT. All patients presented in emergency with the acute severe rise of BP with breathlessness and or visual blurring. All of them showed retinal changes suggestive of malignant hypertension. They needed parenteral therapy to control BP. They also needed the escalation of antihypertensives and the addition of other drugs. One patient needed a withdrawal of rifampicin. It is suggested that children with CKD should be monitored for BP control after instituting ATT.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=6;spage=213;epage=215;aulast=Kumarblood pressuredialysismalignant hypertensionrifampicin
spellingShingle Alok Kumar
Dorchhom Khrime
Utkarsh Sharma
Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
Journal of Pediatric Critical Care
blood pressure
dialysis
malignant hypertension
rifampicin
title Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
title_full Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
title_fullStr Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
title_full_unstemmed Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
title_short Hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy: A case series
title_sort hypertensive crisis in children with chronic kidney disease after instituting antitubercular therapy a case series
topic blood pressure
dialysis
malignant hypertension
rifampicin
url http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=6;spage=213;epage=215;aulast=Kumar
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AT dorchhomkhrime hypertensivecrisisinchildrenwithchronickidneydiseaseafterinstitutingantituberculartherapyacaseseries
AT utkarshsharma hypertensivecrisisinchildrenwithchronickidneydiseaseafterinstitutingantituberculartherapyacaseseries