Children With Kidney Diseases Susceptible to High Blood Pressure

Do you know that high blood pressure is common in children with Chronic Kidney Disease (CKD)? It is common knowledge that high blood pressure (HBP) also known as hypertension is a precursor to most heart problems. Therefore it is important for children with CKD to have a regular blood pressure check up since early detection reduces the risks for complications.

In children, HBP is common among those who are overweight, African American, have CKD and have a family history of high blood pressure. When children are found to have HBP, parents should ensure that they get checked for kidney diseases as these may be an underlying cause. These include: inherited Polycystic Kidney Disease (PKD); Focal Segmental Glomerulosclerosis (FSGS) - referring to damage in the filtering units of the kidneys; and Hemolytic Uremic Syndrome (HUS), which affects the blood and blood vessels; and problems that block urine flow in the urinary tract.

Parents should remember to measure their child's BP by using a blood pressure cuff that covers 80-100% of the circumference of child's arm. There is also special equipment designed for infants and newborns. BP reading for children is similar to that of adults where there is the systolic BP (top number) and the diastolic BP (bottom number). As a person gets older and gains more weight his BP also increases. This means that a normal BP for children would be lower than the normal level for adults. A doctor's pronouncement of HBP should be based on at least two blood pressure checkups. The normal level for children should be less than 130/80. Your child's doctor can tell you the target BP for the child.

When your child has been diagnosed with both CKD and hypertension it is important that a doctor specializing in both diseases for children get involved in his/her care and treatment plan. The treatment may be a combination of lifestyle changes and taking blood pressure pills for children. The pills would include angiotensis converting enzyme inhibitor (ACE) or angiotensis receptor blocker (ARB). Studies have shown that these drugs also protect kidney function. Water pills may also be given to children who have water and salt retention. Most children with CKD need more than one medicine. Your child's doctor will adjust the dosage base on his/her age and weight. As for lifestyle changes, an overweight child needs to lose weight, slow down snacking on salty foods like chips, and exercise regularly.

Your child's BP should be checked every time you visit the doctor. Other important tests for the kidneys include: Glomerular Filtration Rate (to see if the kidneys are functioning properly); and urine protein level to determine if the CKD is getting worse. It also detects the development of heart and blood vessel diseases.