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Article ; Online: Antenatal Programming of Hypertension: Paradigms, Paradoxes, and How We Move Forward.

South, Andrew M / Allen, Norrina B

2022 Volume 24, Issue 12, Page(s) 655–667

Abstract: Purpose of review: Synthesize the clinical, epidemiological, and preclinical evidence for antenatal programming of hypertension and critically appraise paradigms and paradoxes to improve translation.: Recent findings: Clinical and epidemiological ... ...

Abstract	Purpose of review: Synthesize the clinical, epidemiological, and preclinical evidence for antenatal programming of hypertension and critically appraise paradigms and paradoxes to improve translation. Recent findings: Clinical and epidemiological studies persistently demonstrate that antenatal factors contribute to programmed hypertension under the developmental origins of health and disease framework, including lower birth weight, preterm birth, and fetal growth restriction. Preclinical mechanisms include preeclampsia, maternal diabetes, maternal undernutrition, and antenatal corticosteroid exposure. However, clinical and epidemiological studies to date have largely failed to adequately identify, discuss, and mitigate many sources and types of bias in part due to heterogeneous study designs and incomplete adherence to scientific rigor. These limitations have led to incomplete and biased paradigms as well as persistent paradoxes that have significantly limited translation into clinical and population health interventions. Improved understanding of these paradigms and paradoxes will allow us to substantially move the field forward.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Female ; Humans ; Premature Birth/epidemiology ; Hypertension/epidemiology ; Pre-Eclampsia ; Adrenal Cortex Hormones ; Fetal Growth Retardation
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2057367-4
ISSN	1534-3111 ; 1522-6417
ISSN (online)	1534-3111
ISSN	1522-6417
DOI	10.1007/s11906-022-01227-z
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Zs.A 5522: Show issues

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Article ; Online: Correlation between kidney sodium and potassium handling and the renin-angiotensin-aldosterone system in children with hypertensive disorders.

Perrin, Ella C / South, Andrew M

Pediatric nephrology (Berlin, Germany)

2021 Volume 37, Issue 3, Page(s) 633–641

Abstract: Background: Urine sodium and potassium are used as surrogate markers for dietary consumption in adults with hypertension, but their role in youth with hypertension and their association with components of the renin-angiotensin-aldosterone system (RAAS) ... ...

Abstract	Background: Urine sodium and potassium are used as surrogate markers for dietary consumption in adults with hypertension, but their role in youth with hypertension and their association with components of the renin-angiotensin-aldosterone system (RAAS) are incompletely characterized. Some individuals with hypertension may have an abnormal RAAS response to dietary sodium and potassium intake, though this is incompletely described. Our objective was to investigate if plasma renin activity and serum aldosterone are associated with urine sodium and potassium in youth referred for hypertensive disorders. Methods: This pilot study was a cross-sectional analysis of baseline data from 44 youth evaluated for hypertensive disorders in a Hypertension Clinic. We recorded urine sodium and potassium concentrations normalized to urine creatinine, plasma renin activity, and serum aldosterone and calculated the sodium/potassium (UNaK) and aldosterone/renin ratios. We used multivariable generalized linear models to estimate the associations of renin and aldosterone with urine sodium and potassium. Results: Our cohort was diverse (37% non-Hispanic Black, 14% Hispanic), 66% were male, and median age was 15.3 years; 77% had obesity and 9% had a secondary etiology. Aldosterone was associated inversely with urine sodium/creatinine (β: -0.34, 95% CI -0.62 to -0.06) and UNaK (β: -0.09, 95% CI -0.16 to -0.03), and adjusted for estimated glomerular filtration rate and serum potassium. Conclusions: Higher serum aldosterone levels, but not plasma renin activity, were associated with lower urine sodium/creatinine and UNaK at baseline in youth referred for hypertensive disorders. Further characterization of the RAAS could help define hypertension phenotypes and guide management. A higher resolution version of the Graphical abstract is available as supplementary information.
MeSH term(s)	Adolescent ; Aldosterone ; Blood Pressure/physiology ; Creatinine/metabolism ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Kidney ; Male ; Pilot Projects ; Potassium ; Pregnancy ; Renin ; Renin-Angiotensin System/physiology ; Sodium
Chemical Substances	Aldosterone (4964P6T9RB) ; Sodium (9NEZ333N27) ; Creatinine (AYI8EX34EU) ; Renin (EC 3.4.23.15) ; Potassium (RWP5GA015D)
Language	English
Publishing date	2021-09-09
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-021-05204-7
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Zs.A 2196: Show issues

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Article ; Online: Prevalence and risk factors of disordered eating behavior in youth with hypertension disorders.

Perrin, Ella C / Ravi, Hanna L / Borra, Gagana S / South, Andrew M

Pediatric nephrology (Berlin, Germany)

2023 Volume 38, Issue 11, Page(s) 3779–3789

Abstract: Background: Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse ...

Abstract	Background: Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse health consequences. In youth with other conditions requiring lifestyle counseling such as hypertension (HTN), DEB prevalence and associated risk factors are unknown. We hypothesized that youth with HTN disorders would have higher DEB prevalence than the general adolescent population, and that obesity, chronic kidney disease (CKD), and less specialized lifestyle counseling would be associated with higher DEB risk. Methods: Prospective cross-sectional study of youth aged 11-18 years with HTN disorders. We excluded patients with diabetes mellitus, kidney failure or transplantation, or gastrostomy tube dependence. We collected data via surveys and electronic health record abstraction. We administered the validated SCOFF DEB screening questionnaire. We compared DEB prevalence using a one-sample z-test of proportions (p Results: Of 74 participants, 59% identified as male, 22% as Black or African American, and 36% as Hispanic or Latino; 58% had obesity and 26% had CKD. DEB prevalence was 28% (95% CI 18-39%, p < 0.001). CKD was associated with higher DEB prevalence (adjusted RR 2.17, 95% CL 1.09 to 4.32), but obesity and lifestyle counseling source were not. Conclusions: DEB prevalence is higher in youth with HTN disorders and comparable to other conditions requiring lifestyle counseling. Youth with HTN disorders may benefit from DEB screening. A higher resolution version of the Graphical abstract is available as Supplementary information.
MeSH term(s)	Humans ; Male ; Adolescent ; Diabetes Mellitus, Type 1/complications ; Prospective Studies ; Prevalence ; Cross-Sectional Studies ; Risk Factors ; Hypertension/epidemiology ; Hypertension/complications ; Obesity/complications ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/complications ; Feeding and Eating Disorders
Language	English
Publishing date	2023-05-17
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-023-05921-1
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Zs.A 2196: Show issues

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Article ; Online: Management of acute severe hypertension in youth: from the philosophical to the practical.

Giammattei, Victoria C / Weaver, Donald J / South, Andrew M

Current opinion in pediatrics

2022 Volume 35, Issue 2, Page(s) 251–258

Abstract: Purpose of review: Acute severe hypertension remains an uncommon but important source of morbidity and mortality in youth. However, there has been very little progress made in our understanding of how to best manage youth with acute severe hypertension ... ...

Abstract	Purpose of review: Acute severe hypertension remains an uncommon but important source of morbidity and mortality in youth. However, there has been very little progress made in our understanding of how to best manage youth with acute severe hypertension to improve patient outcomes. Recent findings: Our understanding of what is acute severe hypertension is undergoing a philosophical change. Management of patients with acute severe hypertension is evolving towards more of a risk and outcomes-based approach. Summary: We should be intentional when we consider whether a patient has acute severe hypertension and if they are truly at an increased risk for life-threatening target organ injury. We should consider their specific risk factors to best interpret the risks and benefits of how best to treat a patient with acute severe hypertension, rather than relying on traditional approaches and conventional wisdom. We should always ask 'why' when we are pursuing a given management course. Future studies should clearly define the research questions they are investigating to best advance the field to ultimately improve patient outcomes.
MeSH term(s)	Humans ; Adolescent ; Risk Factors ; Forecasting ; Hypertension/diagnosis ; Hypertension/therapy
Language	English
Publishing date	2022-11-25
Publishing country	United States
Document type	Review ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000001209
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Zs.A 3049: Show issues

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Article ; Online: Risk of Obesity and Unhealthy Central Adiposity in Adolescents Born Preterm With Very Low Birthweight Compared to Term-Born Peers.

Brouwer, Ellen Corina Jacoba / Floyd, Whitney N / Jensen, Elizabeth T / O'Connell, Nathaniel / Shaltout, Hossam A / Washburn, Lisa K / South, Andrew M

Childhood obesity (Print)

2024

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2639910-6
ISSN	2153-2176 ; 2153-2168
ISSN (online)	2153-2176
ISSN	2153-2168
DOI	10.1089/chi.2023.0115
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Article: Association of kidney function with posterior reversible encephalopathy syndrome in children.

Shah, Shruti M / South, Andrew M

Clinical nephrology

2020 Volume 98, Issue 1, Page(s) 10–15

Abstract: Aims: Investigate if kidney function markers predict posterior reversible encephalopathy syndrome (PRES) in children.: Materials and methods: In a case-control study of high-risk children with confirmed PRES (n = 35) compared to controls (n = 14), we ...

Abstract	Aims: Investigate if kidney function markers predict posterior reversible encephalopathy syndrome (PRES) in children. Materials and methods: In a case-control study of high-risk children with confirmed PRES (n = 35) compared to controls (n = 14), we recorded blood urea nitrogen (BUN), serum creatinine, serum albumin, hemoglobin concentrations, estimated glomerular filtration rate, and documentation of acute kidney injury (AKI). We applied multivariable regression models and determined receiver operating characteristic curves. Results: Mean age was 9.5 (SD 4.9) years, 51% were female, 29% had chronic kidney disease, 67% had nephrotoxic medication exposure, and 29% had AKI. A 1-mg/dL increase in BUN (adjusted OR 1.03, 95% CI 0.99 - 1.07) and AKI (adjusted OR 3.78, 0.68 - 21.13) were minimally, but not statistically significantly, associated with PRES. BUN = 21.6 mg/dL performed best but had low ability to predict PRES (area under the curve 0.664, 0.498 - 0.831), with 60.0% sensitivity, 71.4% specificity, and positive and negative predictive values of 84.0% and 41.7%, respectively. Conclusion: Kidney function may be a relatively more minor risk factor for PRES than previously believed. Further prospective studies with larger sample sizes and better kidney function assessments are warranted to evaluate the role of kidney function in the development of PRES.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Adolescent ; Biomarkers ; Case-Control Studies ; Child ; Child, Preschool ; Creatinine ; Female ; Humans ; Kidney ; Male ; Posterior Leukoencephalopathy Syndrome/complications ; Posterior Leukoencephalopathy Syndrome/etiology ; Prospective Studies
Chemical Substances	Biomarkers ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2020-12-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	185101-9
ISSN	0301-0430
ISSN	0301-0430
DOI	10.5414/CN110706
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Zs.A 873: Show issues

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Article ; Online: Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight.

Floyd, Whitney N / Beavers, Daniel P / Jensen, Elizabeth T / Washburn, Lisa K / South, Andrew M

Journal of perinatology : official journal of the California Perinatal Association

2023 Volume 43, Issue 8, Page(s) 1038–1044

Abstract: ... ml/min/1.73 m: Conclusion: ANCS exposure was not associated with worse kidney function ...

Abstract	Objective: Investigate if antenatal corticosteroids (ANCS) are associated with worse kidney function in adolescence and if greater adiposity magnifies this association. Study design: Prospective cohort of 162 14-year-olds born preterm with very low birth weight (<1500 g). Outcomes were estimated glomerular filtration rate (eGFR) and first-morning urine albumin-to-creatinine ratio (UACR). We used adjusted generalized linear models, stratified by waist-to-height ratio (WHR) ≥ 0.5. Results: Fifty-five percent had ANCS exposure and 31.3% had WHR ≥ 0.5. In adjusted analyses of the entire cohort, ANCS was not significantly associated with eGFR or UACR. However, the ANCS-eGFR association was greater in those with WHR ≥ 0.5 (β -16.8 ml/min/1.73 m Conclusion: ANCS exposure was not associated with worse kidney function in adolescence, though ANCS may be associated with lower eGFR if children develop obesity by adolescence.
MeSH term(s)	Infant, Newborn ; Child ; Humans ; Female ; Adolescent ; Pregnancy ; Prospective Studies ; Creatinine ; Infant, Very Low Birth Weight ; Obesity ; Glomerular Filtration Rate ; Kidney ; Adrenal Cortex Hormones/adverse effects
Chemical Substances	Creatinine (AYI8EX34EU) ; Adrenal Cortex Hormones
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	645021-0
ISSN	1476-5543 ; 0743-8346
ISSN (online)	1476-5543
ISSN	0743-8346
DOI	10.1038/s41372-023-01688-3
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Zs.A 2412: Show issues

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Article ; Online: Duration of Simultaneous Exposure to High-Risk and Lower-Risk Nephrotoxic Antimicrobials in the Neonatal Intensive Care Unit (NICU) and Future Adolescent Kidney Health.

Schiff, Andrew F / Deines, Danielle / Jensen, Elizabeth T / O'Connell, Nathaniel / Perry, Courtney J / Shaltout, Hossam A / Washburn, Lisa K / South, Andrew M

The Journal of pediatrics

2023 Volume 264, Page(s) 113730

Abstract: ... No participant had eGFR <90 ml/min/1.73 m: Conclusions: Despite frequent simultaneous exposure ...

Abstract	Objective: To determine whether greater duration of simultaneous exposure to antimicrobials with high nephrotoxicity risk combined with lower-risk antimicrobials (simultaneous exposure) in the neonatal intensive care unit (NICU) is associated with worse later kidney health in adolescents born preterm with very low birth weight (VLBW). Study design: Prospective cohort study of participants born preterm with VLBW (<1500 g) as singletons between January 1, 1992, and June 30, 1996. We defined simultaneous exposure as a high-risk antimicrobial, such as vancomycin, administered with a lower-risk antimicrobial on the same date in the NICU. Outcomes were serum creatinine, estimated glomerular filtration rate (eGFR), and first-morning urine albumin-creatinine ratio (ACR) at age 14 years. We fit multivariable linear regression models with days of simultaneous exposure and days of nonsimultaneous exposure as main effects, adjusting for gestational age, birth weight, and birth weight z-score. Results: Of the 147 out of 177 participants who had exposure data, 97% received simultaneous antimicrobials for mean duration 7.2 days (SD 5.6). No participant had eGFR <90 ml/min/1.73 m Conclusions: Despite frequent simultaneous exposure to high-risk combined with lower-risk nephrotoxic antimicrobials in the NICU, there were no clinically relevant associations with worse kidney health identified in adolescence. Although future studies are needed, these findings may provide reassurance in a population thought to be at increased risk of chronic kidney disease.
MeSH term(s)	Infant, Newborn ; Humans ; Adolescent ; Birth Weight ; Intensive Care Units, Neonatal ; Prospective Studies ; Kidney ; Glomerular Filtration Rate ; Anti-Infective Agents
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2023-09-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2023.113730
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Um IV Zs.116: Show issues

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Article ; Online: A historical perspective on ACE2 in the COVID-19 era.

Bhalla, Vivek / Blish, Catherine A / South, Andrew M

Journal of human hypertension

2020 Volume 35, Issue 10, Page(s) 935–939

MeSH term(s)	Angiotensin-Converting Enzyme 2 ; COVID-19 ; Humans ; Renin-Angiotensin System
Chemical Substances	ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
Language	English
Publishing date	2020-12-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	639472-3
ISSN	1476-5527 ; 0950-9240
ISSN (online)	1476-5527
ISSN	0950-9240
DOI	10.1038/s41371-020-00459-3
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Zs.A 2380: Show issues

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Article ; Online: Reply.

South, Andrew M / Alexander, Barbara T / Morrison, Janna L / Sehgal, Arvind

The Journal of pediatrics

2020 Volume 230, Page(s) 275–276

MeSH term(s)	Fetal Growth Retardation ; Humans ; Hypertension ; Medical History Taking
Language	English
Publishing date	2020-11-27
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2020.11.051
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