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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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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

Insights

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.
  • 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.

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