Objective: The aim of our study was to measure systolic pressure wave amplification (brachial minus central systolic blood pressure) in children and to assess anthropometric measures correlated with amplification in children with and without chronic kidney disease (CKD).

Design and Methods: In a prospective single centre study 150 children (103 with non-dialysis CKD, 23 with hypertension) aged 12.9 ± 2.9 years (81 boys) were recruited from the paediatric nephrology and hypertension out-patient clinics at the Evelina London Children’s Hospital. Peripheral blood pressure was measured manually, in triplicate, by aneroid sphygmomanometer. Central blood pressure and carotid-femoral pulse wave velocity (cfPWV) were measured in triplicate using the SphygmoCor system. Renal function was determined by estimated GFR (eGFR) using the Schwartz formula.

Results: Mean amplification (mean ± SD) was 18.8 ± 6.4 mmHg. Systolic pressure amplification was significantly different across age groups of children 5–10 years (16.3 ± 4.8 mmHg), 10–15 years (18.2 ± 5.2 mmHg) and 15–18 years (21.0 ± 7.3 mmHg) (p = 0.003). In univariate analysis amplification was correlated with age, height, weight, BMI, and eGFR. It was not correlated with gender, ethnicity or cfPWV. In multivariate linear regression analysis including age, gender, height, BMI, and eGFR, amplification was independently associated with height, BMI and eGFR (β=0.213, P=0.012; β=0.264, P=0.002; β=0.206, P=0.006, respectively, model adjusted R2=0.203).

Conclusions: Amplification is greater in adolescents (15–18 years) than in younger children (5–10 years) and is independently associated with BMI, height, and renal function.