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Minerva Pediatr ; 64(2): 171-82, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22495191

ABSTRACT

A variety of chronic kidney diseases tend to progress towards end-stage kidney disease. Progression is largely due to factors unrelated to the initial disease, including arterial hypertension and proteinuria. Intensive treatment of these two factors is potentially able to slow the progression of kidney disease. Blockers of the renin-angiotensin-aldosterone system, either converting enzyme inhibitors or angiotensin II receptor antagonists, reduce both blood pressure and proteinuria and appear superior to a conventional antihypertensive treatment regimen in preventing progression to end-stage kidney disease. The most recent recommendations state that in children with chronic kidney disease without proteinuria the blood pressure goal is the corresponding 75th centile for body length, age and gender; whereas the 50th centile should be aimed in children with chronic kidney disease and pathologically increased proteinuria.


Subject(s)
Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Proteinuria/prevention & control , Renal Insufficiency, Chronic/drug therapy , Renin-Angiotensin System/drug effects , Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Antihypertensive Agents/adverse effects , Blood Pressure/drug effects , Child , Disease Progression , Humans , Hypertension/complications , Hypertension/physiopathology , Kidney Failure, Chronic/prevention & control , Proteinuria/etiology , Randomized Controlled Trials as Topic , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/physiopathology , Risk Factors , Treatment Outcome
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