Blood-Pressure Control and Delay in Progression of Kidney Disease in Children

Abstract

Many children with chronic kidney disease, even those in whom the disease is discovered very early, ultimately lose renal function; some ultimately progress to stage 5 chronic kidney disease (end-stage renal disease). Causes of chronic kidney disease in children differ substantially from those in adults; the largest diagnostic categories in children are congenital renal and genitourinary abnormalities; obstructive uropathy or renal hypoplasia–dysplasia are most common, followed by reflux nephropathy and focal segmental glomerulosclerosis.1,2 Despite much evidence that blocking the renin–angiotensin system is helpful in treating adults with various nephropathies,3 comparable data from randomized, controlled trials involving children are lacking. . . .