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• W2003404235 abstract "Arterial hypertension is very common in children with all stages of chronic kidney disease (CKD). While fluid overload and activation of the renin-angiotensin system have long been recognized as crucial pathophysiological pathways, sympathetic hyperactivation, endothelial dysfunction and chronic hyperparathyroidism have more recently been identified as important factors contributing to CKD-associated hypertension. Moreover, several drugs commonly administered in CKD, such as erythropoietin, glucocorticoids and cyclosporine A, independently raise blood pressure in a dose-dependent fashion. Because of the deleterious consequences of hypertension on the progression of renal disease and cardiovascular outcomes, an active screening approach should be adapted in patients with all stages of CKD. Before one starts antihypertensive treatment, non-pharmacological options should be explored. In hemodialysis patients a low salt diet, low dialysate sodium and stricter dialysis towards dry weight can often achieve adequate blood pressure control. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers are first-line therapy for patients with proteinuria, due to their additional anti-proteinuric properties. Diuretics are a useful alternative for non-proteinuric patients or as an add-on to renin-angiotensin system blockade. Multiple drug therapy is often needed to maintain blood pressure below the 90th percentile target, but adequate blood pressure control is essential for better renal and cardiovascular long-term outcomes." @default.
• W2003404235 created "2016-06-24" @default.
• W2003404235 creator A5038547566 @default.
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• W2003404235 date "2007-11-08" @default.
• W2003404235 modified "2023-10-18" @default.
• W2003404235 title "Hypertension in children with chronic kidney disease: pathophysiology and management" @default.
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• W2003404235 doi "https://doi.org/10.1007/s00467-007-0643-7" @default.
• W2003404235 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/2214827" @default.
• W2003404235 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/17990006" @default.
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