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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...

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Updated: May 29, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Hypertension and CKD.

Rene G VanDeVoorde1, Mark M Mitsnefes

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.

Advances in Chronic Kidney Disease
|September 8, 2011
PubMed
Summary

Hypertension affects over half of pediatric patients with chronic kidney disease (CKD), with aggressive blood pressure control crucial for preventing cardiovascular issues and slowing CKD progression.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Health in Children
  • Chronic Kidney Disease (CKD) Management

Background:

  • Hypertension is prevalent in over 50% of pediatric patients with chronic kidney disease (CKD).
  • Prevalence varies by CKD etiology, with acquired renal disorders showing higher rates similar to adults.
  • Masked hypertension is also common in children with CKD, as indicated by ambulatory blood pressure monitoring.

Purpose of the Study:

  • To highlight the significant prevalence of hypertension in pediatric CKD.
  • To emphasize the link between uncontrolled hypertension and CKD progression and end-organ damage.
  • To underscore the importance of aggressive hypertension management in pediatric CKD care.

Main Methods:

  • Review of existing literature and clinical findings on hypertension in pediatric CKD.

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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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  • Analysis of ambulatory blood pressure monitoring data.
  • Consideration of outcomes from major clinical trials like the ESCAPE trial.

    • Main Results:

    • Hypertension is a common comorbidity in pediatric CKD, particularly with acquired renal disorders.
    • Uncontrolled hypertension accelerates CKD progression and leads to end-organ damage (cardiomyopathy, atherosclerosis).
    • Aggressive blood pressure control, targeting below the 50th percentile, shows significant benefits in pediatric CKD patients.

    Conclusions:

    • Aggressive treatment of hypertension is essential for managing pediatric CKD.
    • Effective blood pressure management can prevent cardiovascular complications and delay CKD progression.
    • Targeting blood pressure below the 50th percentile offers greater benefits in pediatric CKD than observed in adult studies.