Cohort studies such as Chronic Kidney Disease in Children (CKiD) and Cardiovascular Comorbidity in Children with CKD (4C) have continued to develop our understanding of blood pressure (BP) phenotypes, and of progressive changes in the structure and function of the heart and blood vessels occurring in children with CKD. Metabolic risk factors, such as dyslipidemia, may represent an under-recognized component of care. Trial data are less common than observational evidence, but support lifestyle interventions currently used, mainly the low sodium dietary approaches to stop hypertension (DASH) diet. The findings of the recently reported Hypertension Optimal Treatment in Children with Chronic Kidney Disease trial (HOT-KID) are described in relation to the use of office BP treatment targets. Cardiovascular health is critical to the long-term outcomes of children with CKD. Recognizing and treating hypertension remains a critical component to improving outcomes, along with measures to improve concurrent cardiovascular risk factors. Some cardiovascular changes may not be reversible with transplantation and further research is needed for children at all stages of CKD.
Keyphrases
- chronic kidney disease
- blood pressure
- young adults
- end stage renal disease
- risk factors
- cardiovascular risk factors
- metabolic syndrome
- clinical trial
- healthcare
- physical activity
- squamous cell carcinoma
- randomized controlled trial
- study protocol
- adipose tissue
- atrial fibrillation
- machine learning
- hypertensive patients
- deep learning
- insulin resistance
- pain management
- cell therapy
- chronic pain
- phase iii
- locally advanced