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Management of Hypertension in Pediatric Dialysis Patients

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Pediatric Dialysis

Abstract

Hypertension is common among both peritoneal and hemodialysis patients. It is an important modifiable condition, and one of the most important contributors to the excess morbidity and mortality in this population. Accurate diagnosis with appropriate blood pressure measurement, especially with the use of ambulatory blood pressure monitoring, is crucial in order to achieve optimal blood pressure control. Achievement of dry weight during dialysis and avoidance of excessive interdialytic weight gain are the most important therapeutic strategies. When hypertension persists despite the achievement of euvolemia, antihypertensive medications may be required, and in some patients, native kidney nephrectomies.

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Abbreviations

ABPM:

ambulatory blood pressure monitoring

ACEi:

angiotensin converting enzyme inhibitor

BP:

blood pressure

CAKUT:

congenital anomalies of kidney and urinary tract

ESRD:

end-stage renal disease

HD:

hemodialysis

LVH:

left ventricular hypertrophy

NO:

nitric oxide

PD:

peritoneal dialysis

PTH:

parathyroid hormone

PWV:

pulse wave velocity

RAAS:

renin-angiotensin-aldosterone-system

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Authors and Affiliations

  1. Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Division of Pediatric Nephrology, Heidelberg, Germany

    Elke Wühl

  2. University of Washington School of Medicine, Division of Nephrology, Seattle Children’s Hospital, Seattle, WA, USA

    Joseph T. Flynn

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  1. Elke Wühl
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  2. Joseph T. Flynn
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Correspondence to Joseph T. Flynn .

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Editors and Affiliations

  1. Department of Pediatrics, University of Missouri-Kansas City, School of Medicine, Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A. Warady

  2. Stanford University School of Medicine, Division of Pediatric Nephrology, Department of Pediatrics, Palo Alto, CA, USA

    Steven R. Alexander

  3. Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany

    Franz Schaefer

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Wühl, E., Flynn, J.T. (2021). Management of Hypertension in Pediatric Dialysis Patients. In: Warady, B.A., Alexander, S.R., Schaefer, F. (eds) Pediatric Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-66861-7_31

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