Published online before print August 25, 2008, doi: 10.1161/HYPERTENSIONAHA.108.117242
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(Hypertension. 2008;52:610.)
© 2008 American Heart Association, Inc.
Editorial Commentaries |
Hypertension in Children With Chronic Kidney Disease
A Call to Action
From the Divisions of Nephrology (C.A.P.) and General Internal Medicine (M.G.S.), San Francisco VA Medical Center; and the Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco.
Correspondence to Michael G. Shlipak, MD, MPH, General Internal Medicine Section, VA Medical Center (111A1), 4150 Clement St, San Francisco, CA 94121. E-mail Michael.shlipak@ucsf.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
In this issue of Hypertension, Flynn et al report novel findings from the Chronic Kidney Disease in Children (CKiD) study on the prevalence of elevated blood pressure in a cohort of children with chronic kidney disease (CKD).1 CKiD is a well-characterized, cohort study to identify risk factors for kidney disease progression in children. It includes 540 children ages 1 to 16 years with CKD (estimated glomerular filtration rate 30 to 75 mL/min per 1.73 m2).2 In this article from the CKiD, the authors report characteristics associated both with high blood pressure and uncontrolled hypertension in children with CKD. The authors used the following definitions: prehypertensive, age-specific blood pressure 
90th and <95th percentile and hypertensive blood pressure as 95th percentile. The presence of hypertension was defined as having either a systolic blood pressure or diastolic blood pressure 95th percentile or both a self-reported history of high blood pressure and current treatment with antihypertensive medications. Using these definitions, the authors report a very high prevalence of hypertension (54%) in this cohort. In adjusted analyses, black race was significantly associated with higher blood pressure levels. Among 275 children receiving antihypertensive medications, the authors also reported that 98 (36%) had uncontrolled hypertension. In adjusted analyses, use of angiotensin-converting enzyme inhibitors (ACEIs) was associated with better hypertension control.
What makes this study important? To readers familiar with the hypertension literature in adults, these findings may not seem at all surprising. In adults, hypertension is common among persons with CKD, and hypertension prevalence is
Related Article:
Hypertension 2008 52: 631-637.