Management of Hypertension in CAKUT: Protective Factor for CKD

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGABRIELE, Marina M.
dc.contributor.authorNOGUEIRA, Paulo C. Koch
dc.date.accessioned2019-06-26T17:34:39Z
dc.date.available2019-06-26T17:34:39Z
dc.date.issued2019
dc.description.abstractPatients with congenital kidney and urinary tract abnormalities (CAKUT) will often develop end-stage renal disease at some point and the need for renal replacement therapy is associated with high rates of morbidity and mortality. Hence, efforts to slow the progression of the disease are essential. Hypertension has been proven to be an independent risk factor for faster decline of glomerular filtration rate in renal patients, but studies involving only children with CAKUT are scarce. We performed a literature review to explore the association of hypertension with faster chronic kidney disease progression in children with CAKUT and also treatment options in this condition. A recent study reported an annual decline in GFR of 1.8 ml/min/1.73 m(2) among hypertensive patients with non-glomerular CKD, compared with 0.8 ml/min/1.73 m(2) in normotensive children. A multicenter prospective cohort in Brazil showed that a 1-unit increase in systolic blood pressure Z-score was associated with a 1.5-fold higher risk of disease progression. Since renin-angiotensin-aldosterone system activation is the most important mechanism of hypertension in these children, the first-line therapy involves the use of inhibitors of this axis, including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers type I, which also promote an anti-fibrotic effect. Recent studies have shown a good safety profile for use in patients with chronic kidney disease and also in those with solitary kidneys. Hypertension is an independent risk factor for kidney disease progression and should be promptly managed for renal protection, especially among patients with CAKUT, the primary cause of chronic kidney disease in the pediatric population.eng
dc.description.indexPubMedeng
dc.identifier.citationFRONTIERS IN PEDIATRICS, v.7, article ID 222, 6p, 2019
dc.identifier.doi10.3389/fped.2019.00222
dc.identifier.issn2296-2360
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/32585
dc.language.isoeng
dc.publisherFRONTIERS MEDIA SAeng
dc.relation.ispartofFrontiers in Pediatrics
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright FRONTIERS MEDIA SAeng
dc.subjectCAKUTeng
dc.subjectchronic kidney disease (CKD)eng
dc.subjecthypertensioneng
dc.subjectrenal disease progressioneng
dc.subjectrisk factoreng
dc.subjectchildreneng
dc.subjectblood pressureeng
dc.subject.otherchronic kidney-diseaseeng
dc.subject.otherblood-pressure controleng
dc.subject.otherchronic-renal-failureeng
dc.subject.otherchildreneng
dc.subject.otherprogressioneng
dc.subject.otheradolescentseng
dc.subject.otherguidelineseng
dc.subject.otherefficacyeng
dc.subject.otherriskeng
dc.subject.otherdieteng
dc.subject.wosPediatricseng
dc.titleManagement of Hypertension in CAKUT: Protective Factor for CKDeng
dc.typearticleeng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalNOGUEIRA, Paulo C. Koch:Univ Fed Sao Paulo, Escola Paulista Med, Pediat Nephrol Dept, Sao Paulo, Brazil; Samaritan Hosp Sao Paulo, Sao Paulo, Brazil
hcfmusp.citation.scopus14
hcfmusp.contributor.author-fmusphcMARINA MATTIELLO GABRIELE
hcfmusp.description.articlenumber222
hcfmusp.description.volume7
hcfmusp.origemWOS
hcfmusp.origem.scopus2-s2.0-85068902301
hcfmusp.origem.wosWOS:000470207600001
hcfmusp.publisher.cityLAUSANNEeng
hcfmusp.publisher.countrySWITZERLANDeng
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