A Study to Estimate the Proportion and Factors Associated with Hypertension in Paediatric Nephrotic Syndrome Patients in a Tertiary Care Centre

Background: Nephrotic syndrome (NS) is a common pediatric renal disorder characterized by proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Hypertension is an important but often under-recognized comorbidity that may contribute to long-term cardiovascular complications. Material and Methods: A hospital-based cross-sectional observational study was conducted among 54 children aged 1–18 years with nephrotic syndrome admitted to a tertiary care center. Detailed clinical evaluation, laboratory investigations, and blood pressure assessment using standard pediatric guidelines were performed. Hypertensive patients underwent echocardiographic evaluation for cardiac end-organ damage. Statistical analysis was performed using appropriate tests, with p < 0.05 considered significant. Results: The prevalence of hypertension was 24.07% (13/54). Sociodemographic factors such as age, gender, and socioeconomic status were not significantly associated with hypertension (p > 0.05). Clinical variables showed strong associations, with hypertension being more common in steroid-dependent nephrotic syndrome (69.2%), frequent relapses (76.9%), higher relapse frequency, poor compliance (69.2%), immunomodulator use (53.8%), and prolonged steroid therapy >6 months (90.0%) (p < 0.05). Laboratory parameters, including serum albumin, cholesterol, creatinine, and eGFR, were comparable between groups. Echocardiography revealed left ventricular hypertrophy in only one patient (8.3%), with no cases of concentric hypertrophy. Conclusion: Hypertension affects nearly one-fourth of children with nephrotic syndrome and is primarily associated with disease severity and treatment-related factors rather than demographic or laboratory variables. Early detection, regular monitoring, and improved treatment adherence are essential to reduce long-term cardiovascular risk.

Keywords: Nephrotic syndrome, Pediatric hypertension, Steroid-dependent nephrotic syndrome, Relapse pattern, Left ventricular hypertrophy.