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      Hypertension in children with end-stage renal disease.

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          Abstract

          This review summarizes current data on the epidemiology, pathophysiology, and treatment of hypertension (HTN) in children with end-stage renal disease (ESRD). Worldwide prevalence of ESRD ranges from 5.0 to 84.4 per million age-related population. HTN is present in 27-79% of children with ESRD, depending on the modality of renal replacement therapy and the exact definition of hypertension. Ambulatory BP monitoring has been recommended for the detection of HTN and evaluation of treatment effectiveness. HTN in dialyzed patients is mostly related to hypervolemia, sodium overload, activation of the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system, impaired nitric oxide synthesis, reduced vitamin D levels, and effects of microRNA. In children undergoing chronic dialysis therapy, important factors include optimization of renal replacement therapy and preservation of residual renal function, allowing reduction of volume- and sodium-overload, along with appropriate drug treatment, particularly with calcium channel blockers, RAAS inhibitors, and loop diuretics.

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          Author and article information

          Journal
          Adv Med Sci
          Advances in medical sciences
          1898-4002
          1896-1126
          Sep 2015
          : 60
          : 2
          Affiliations
          [1 ] Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.
          [2 ] Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland. Electronic address: pskrzyp@gmail.com.
          Article
          S1896-1126(15)00037-1
          10.1016/j.advms.2015.07.001
          26275711
          Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

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