Severe hypertension in children with renal disease: treatment with minoxidil

Sixteen children with renal disease and severe hypertension refractory to other drugs were treated with minoxidil for periods of five days to 77 months. The maximum dose ranged from 0.05 to 1.88 mg/kg/d. With therapy, the mean BP decreased from 158/112 to 133/90. Thirteen children had an antihypertensive response. 2 had progressive rejection of transplanted kidneys, and 1 received a low dose and failed to respond. Complications were hypertrichosis in 14; fluid retention in 4, with congestive heart failure in 1; and decreased renal function in 2. Pericarditis, possibly related to minoxidil, occurred in one child. Minoxidil is a valuable antihypertensive drug in children but should be used with caution.