Hypertension and Cardiovascular Risk Among Children with Chronic Kidney Disease.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Hypertension Reports Pub Date : 2024-10-01 Epub Date: 2024-05-28 DOI:10.1007/s11906-024-01308-1
Nicholas G Larkins, Jonathan C Craig
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Abstract

Purpose of review: Cardiovascular disease is the most common cause of mortality across the lifespan of children with chronic kidney disease (CKD). Hypertension is a common and important contributor, but other factors such as obesity, dyslipidemia and mineral bone disease play a role. This narrative review focusses on studies published in the past five years that have investigated hypertension and cardiovascular risk among children with CKD.

Recent findings: Cohort studies such as Chronic Kidney Disease in Children (CKiD) and Cardiovascular Comorbidity in Children with CKD (4C) have continued to develop our understanding of blood pressure (BP) phenotypes, and of progressive changes in the structure and function of the heart and blood vessels occurring in children with CKD. Metabolic risk factors, such as dyslipidemia, may represent an under-recognized component of care. Trial data are less common than observational evidence, but support lifestyle interventions currently used, mainly the low sodium dietary approaches to stop hypertension (DASH) diet. The findings of the recently reported Hypertension Optimal Treatment in Children with Chronic Kidney Disease trial (HOT-KID) are described in relation to the use of office BP treatment targets. Cardiovascular health is critical to the long-term outcomes of children with CKD. Recognizing and treating hypertension remains a critical component to improving outcomes, along with measures to improve concurrent cardiovascular risk factors. Some cardiovascular changes may not be reversible with transplantation and further research is needed for children at all stages of CKD.

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慢性肾病儿童的高血压和心血管风险。
综述目的:心血管疾病是慢性肾脏病(CKD)患儿一生中最常见的死亡原因。高血压是常见的重要诱因,但肥胖、血脂异常和矿物质骨病等其他因素也起着一定作用。这篇叙述性综述重点关注过去五年中发表的有关 CKD 儿童高血压和心血管风险的研究:儿童慢性肾脏病(CKiD)和儿童慢性肾脏病心血管并发症(4C)等队列研究不断加深了我们对儿童慢性肾脏病患者血压(BP)表型以及心脏和血管结构和功能逐渐变化的了解。代谢风险因素,如血脂异常,可能是护理中未被充分认识到的一部分。与观察证据相比,试验数据并不常见,但支持目前使用的生活方式干预措施,主要是低钠饮食法来阻止高血压(DASH)饮食。最近报道的慢性肾病儿童高血压最佳治疗试验(HOT-KID)的研究结果介绍了诊室血压治疗目标的使用情况。心血管健康对慢性肾脏病患儿的长期预后至关重要。识别和治疗高血压以及采取措施改善并发心血管风险因素仍然是改善预后的关键因素。有些心血管变化可能无法通过移植而逆转,因此需要对处于 CKD 各个阶段的儿童进行进一步研究。
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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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