Role of hypertension in progression of chronic kidney disease in children

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations

Abstract

Purpose of review Hypertension is an independent risk factor for progression of chronic kidney disease (CKD) in children. Children with early CKD develop hypertension secondary to renal disease. This review aims to highlight recent advances that help us better understand the current role of hypertension in progression of CKD in children. Recent findings There is increasing evidence that children with CKD who have hypertension develop early atherosclerosis and cardiac adaptive changes. Emerging data from pediatric research in CKD show that elevated blood pressure is associated with the presence of abnormal subclinical markers of cardiovascular disease including increased carotid intima-media thickness, pulse wave velocity and left ventricular mass index. There is also some evidence that these early cardiovascular changes are reversible. Twenty-four hour ambulatory blood pressure monitoring (ABPM) is recommended in children with CKD by the American Academy of Pediatrics to diagnose hypertension. Summary Hypertension is associated with subclinical cardiovascular disease in children with CKD. Early diagnosis of hypertension by ABPM and identification of subclinical cardiovascular changes provide a window for intervention, which may reverse early cardiovascular disease, thereby delaying dialysis and improving cardiovascular morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)247-251
Number of pages5
JournalCurrent opinion in pediatrics
Volume30
Issue number2
DOIs
StatePublished - Apr 1 2018

Keywords

  • cardiovascular disease
  • chronic kidney disease
  • hypertension
  • pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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