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Hypertension Management Dynamics in Pediatric CKD: Insights From the 4C Study
Anke Doyon1, Aysun Karabay Bayazit2, Ali Duzova3
1Heidelberg University, Medical Faculty Heidelberg, Center for Pediatrics and Adolescent Medicine, Division of Pediatric Nephrology, Germany (A. Doyon, E.W., F.S.).
Hypertension (Dallas, Tex. : 1979)
|April 8, 2025
Summary
Office blood pressure trajectories in children with chronic kidney disease reveal that intensified antihypertensive treatment improved blood pressure control. However, some normotensive children developed new-onset hypertension, indicating variable disease progression.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health in Chronic Illness
- Hypertension Management
Background:
- Office blood pressure (BP) monitoring is crucial for assessing hypertension progression in pediatric chronic kidney disease (CKD).
- Understanding BP trajectories aids in evaluating antihypertensive treatment efficacy in children with CKD.
Purpose of the Study:
- To analyze blood pressure (BP) trajectories and antihypertensive treatment patterns in children with CKD.
- To assess the impact of intensified antihypertensive therapy on BP control in this cohort.
Main Methods:
- Analysis of 320 children from the 4C study cohort with CKD before renal replacement therapy.
- Minimum of 3 observations and 2 years of follow-up were required.
- Evaluation of BP slopes and antihypertensive treatment initiation/intensification.
Main Results:
- Overall BP SD scores remained stable in the cohort.
- The group with intensified antihypertensive treatment (AHT-I) showed significant decreases in BP SD scores.
- A notable percentage of normotensive children at baseline developed new-onset hypertension during follow-up.
Conclusions:
- Individual BP management patterns in pediatric CKD are highly variable.
- Intensified antihypertensive therapy significantly improves BP control.
- A substantial proportion of normotensive children with CKD may develop hypertension over time.
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