Treatment of ADPKD with High Blood Pressure in Children and Adolescents
Children and adolescents under 18 with autosomal dominant polycystic kidney disease (ADPKD) who also have high blood pressure require a targeted, evidence-based pharmacologic approach. Blood pressure management in this age group is a defined clinical priority within the ADPKD protocol.
Clinical scenario: Children and adolescents (age <18 years) with ADPKD and high blood pressure. This population warrants first-line pharmacologic treatment selected specifically for this combination.
Treatment approach
Evidence-based guidance specifies a renin-angiotensin system inhibitor as the recommended first-line pharmacologic therapy for high blood pressure in this setting. The complete agent selection, criteria, and regimen are available in the full protocol.
Blood pressure targets
The protocol defines blood pressure targets adjusted for age, sex, and height in children, with a separate numeric threshold for adolescents. Achieving these targets is the primary measure of treatment success.
References
DOI: 10.1016/j.kint.2024.07.010
We recommend use of RASi (i.e., ACEi or ARBs) as the first-line pharmacologic therapy for high BP in children and adolescents with ADPKD (1D).
We recommend targeting BP to ≤50th percentile for age, sex, and height or ≤110/70 mm Hg in adolescents in the setting of ADPKD and high BP (1D).
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