High blood pressure and chronic kidney disease that matter your children--a parental guidance

A parental guidance about how high blood pressure and chronic kidney disease that matter your children

High blood pressure among children with CKD (Chronic Kidney Disease) is a common syndrome. Since these children have high blood pressure and develop CKD, it is most common that these children face heart problems or may have worsening stage of CKD. The children, who are suffering from CKD, should have a regular blood pressure checkup. If the problem is early detected and the treatment is also initiated in an early stage, the complications can be reduced to a significant label. All the parents must take care that they are well aware of their children’s high blood pressure detection and their treatments are always regular.

The chronic kidney disease or CKD

If kidney is damaged due to some disease(s), the condition is known as Chronic Kidney Disease or CKD. In this stage, the children’s kidneys will not be in a position to carry on the following jobs:-

Æ Controlling blood pressure

Æ Promoting strong bones

Æ Maintaining the balance of acids and bases within the body

Æ Preventing low blood count or anaemia

Æ Controlling blood pressure

Æ Making hormones that help in promoting normal growth & development

Æ Releasing certain hormones which are very essentials for the children’s growth

Æ Keeping the right balance of important chemicals such as calcium, phosphorous, potassium and sodium in the blood, and

Æ The most important one is removing the extra fluids and wastes from the body.

What happens if kidneys do not work properly

In case of improper working of kidneys, build ups of wastes in the blood will be too much. This will result in swelling in the hands & feet, poor appetite, fatigue, vomiting and nausea. Other complications like weak bones, high blood pressure, nerve damage, growth failure, poor nutritional health and anemia are the common phenomena. Further to it, due to kidney disease other issues like blood and heart vessel diseases are most likely to cause harm to the affected person. These problems affect the ailing person over a period of time, but without any type of symptom. The eventuality of CKD is kidney failure. In this situation, a patient needs either dialysis or kidney transplantation, for maintaining his/her life. If CKD is detected at the earlier stage, worsening or preventing of the complications can be prevented.

Causes of CKD in children and adults

Most of the adults become the victims of CKD due to high blood sugar and diabetes. However, as on date, this is not the case with the children. But it is a fact that more numbers of children are becoming the victims of high blood pressure and diabetes, the major cause in this case is over weight of the children. Overweight leads to serious health problems like CKD, high blood cholesterol, high blood pressure and diabetes.

In these days, children with CKD are found to be the victims of:

Ø PKD, polycystic kidney disease, which is one of the inherited diseases is due to the filled-up fluids (as pouches) in the kidneys and is the cause for getting enlarged over a time period.

Ø Normal flow of urine gets blocked due to the problems in the urinary tract.

Ø HUS (Hemolytic uremic syndrome) is such a problem that affects both blood and blood vessels.  Because of damage to the small blood vessels in the kidneys, kidneys fail to function. The further damages HUS can cause to other organs are brain and heart complications.

Ø Once glomeruli (the filtering units in the kidneys) are damaged, the condition will lead to FSGS (focal segmental glomerulosclerosis).

What do you mean by high blood pressure, in general?

Our heart pumps blood for the entire systems of our body. Blood pressure is the force of blood against the blood vessels’ walls. The too much of such force means a person has hypertension or high blood pressure.

What are the reasons of high blood pressure among the children?

Like adults, children are also the victims of high blood pressure. The reason being:

è Having CKD

è Family history of high blood pressure

è Overweight

è Origin of African-American

In case a child is diagnosed with blood pressure, the doctors need to check the child for kidney disease also, because both of them are thickly connected with each other.

The relation between CKD and high blood pressure

Among adults, CKD is caused by the high blood pressure that further worsens the conditions if the cases are children. Because of high blood pressure, complication of kidney disease is common phenomena. The roles of the kidneys are to keep the blood pressure in a healthy condition. Whether it is a child or an adult, if the kidneys are damaged, the damaged kidneys cannot regulate blood pressure. This ultimately results to further increase in the blood pressure; the condition of CKD gets worse. If you are carefully following your child’s treatment plan you can see that your child’s blood pressure is under control and the child’s kidney and heart disease will be prevented from getting worse.

How to check child’s blood pressure?

A blood pressure cuff, which is appropriate to the child’s age and size, is used for measuring your child’s blood pressure. Cuffs are available on different sizes to suit the age and size of the child. Ambulatory monitoring of blood pressure is also the other way of checking the blood pressure of a child. A period of time is involved for this system to check blood pressure. The child can carry on his/her daily activities. There is some other special system for monitoring the blood pressure of the new-borns and the infants.

What is the meaning of the numbers in the blood pressure reading?

Two numbers are used for reading blood pressure both for the adults and the children. The top number is systolic blood pressure. In this situation, heart pumps blood around the body. The bottom number is the diastolic blood pressure. In this situation, the heart rests between the beats. If a blood pressure reads 130/80, it reads 130 over 80.

How to know about high blood pressure in a child?

The difference between the readings of the blood pressure between a child and an adult is, normally the blood pressure is lower in children. The blood pressure increases with the body size and age of a person. A child’s age, height and gender are the issues that reflect about the blood pressure of a child. A standardised chart for boys and girls is tallied for checking blood pressure as per their height and age. A high blood pressure is read by two readings. The readings of a child’s blood pressure are normally studied by at least three separate visits to the doctor. The doctor will say whether your child’s blood pressure is high.

What should be the goals of treating a child’s blood pressure?

The goals of treating a child’s high blood pressure are:

The 1st one is reducing the blood pressure.

The 2nd one is preventing the kidney disease of your child from getting worse

The 3rd one is preventing any type of disease that relates to the child’s heart and blood vessel.

The preventive measures:

The blood pressure of your child should be reduced to a normal level, which will be in accordance to the height, age and sex of the child.

The type of treatment you child needs for reducing blood pressure

Both the medication and life style changes are essential for treating your child with high blood pressure. Only the kidney and high blood pressure specialist doctors should be involved in treating your child’s high blood pressure.

Lifestyle changes needed for your child with high blood pressure

Following recommendations are made by a blood sugar or kidney specialist for treating a child with high blood pressure:

1) Reducing the over weight of your child: - If your child is overweight. Because being over weight, your child may develop some other serious health problems like heart disease, diabetes and the existing blood pressure to a worsening stage.

2) Cutting down the intake of salty snacks and table salts: - One most important point to note here, you doctor must check whether your child has the problem of losing salt due to some type of kidney disease.

3) Avoiding some substances: - Substances like caffeine, tobacco or any other medication should be avoided for bringing down blood pressure.

4) Regular exercise: - A regular exercise that suits your child’s medical condition and age should be practiced. Your child’s blood pressure can not only be reduced by increasing physical activities, your child’s overweight can also be brought down. A healthy child must follow all the good practices like sports and exercise programs in his/her school. But never forget to consult your doctor before your child joins any such programs.

Medication of your child

A child with high blood pressure or CKD needs following things for his/her medications:

i) The child’s type and severity of CKD

ii) Age & size of the child

iii) Ability of the child to swallow pill

All types of blood pressure medicines are tested before they enter in the market. So, your child’s doctor knows better which will be the best medicines for your child. According to the suggestion of some studies, the tested medicines are helpful in protecting the kidney function of your child. In case your child retains water and salt, doctor will suggest some different medicine. Many children with CKD need more than one type of medicines. All the medicines are dependent on the height and age of your child.

How often a child’s blood pressure should be checked?

Blood pressure of your child can be taken at home. Even the school nurse can also check your child’s blood pressure. So keep a record of the blood pressure readings, when taken at home or at school and show it to your child’s doctor, as and when you visit your child’s doctor. Further to this, whenever you visit your doctor, your doctor will check your child’s blood pressure. Be honest to take the readings of the blood pressure of your child, because your doctor may see many points, what you may not have known. Sometimes your child’s doctor will give you a chart to be filled in.

What are the other tests needed for a child with high blood pressure?

As a follow up high blood pressure check, your doctor will also check the condition and working of your child’s kidney. A GFR or glomerular filtration rate tells about your child’s kidney & its working condition. The calculation of GFR is done through a simple blood test for creatinine. The wastes from muscle activity are known as creatinine, which is formed due to the improper functioning of kidneys.

High urine protein level is a serious condition for which your child may have kidney disease. Once a kidney disease is detected, the further problem is likely to be worsening of the kidney disease, which may also add the developments of heart and blood vessels diseases.  If high blood pressure is treated, it may reduce the high urine protein level.

What are the roles of parents in helping their child with high blood pressure?

i) Your child’s overweight must be considered very seriously by you, so you must see that you child sheds extra weight by taking necessary steps as prescribed by the doctor. As a parent, you must never allow your child to take extra amount of calorie at any given time in a day. The most important thing is your child must be educated about the ill effects of overeating and intakes of salty items & snacks.

ii) You must talk to your child’s doctor about the right exercises your child should have. If some medications have been prescribed by your child’s doctor, make sure that the medication is strictly adhered to. In case your child has any side effect due to medication, let it be immediately known to the doctor.

What else can be done?

If at all you have anything to discuss about your child’s health, be frank to your doctor or to the other health personnel taking care of your child’s health.

Final warnings and key points to remember

Ø Children with CKD do commonly have high blood pressure

Ø Any child’s high blood pressure must be checked at regular intervals. This is a preventive measure from getting the kidney or heart and vascular diseases getting worsened.

Ø A cuff, fitting with the age and height of the child, is used to check the blood pressure of your child.

Ø The ailing child must be under the treatment of specialist doctors.

Ø Normally, blood pressure is lower among children. Doctors will compare your child’s blood pressure reading with the standard chart and match with the age, sex and size of the child.  This will help the doctor in determining the level of blood pressure you child has.

Ø Your child’s sex, size and age will depend upon the alteration/closer of the medication.


The high blood pressure treatment needs changes in lifestyle, appropriate medications, taking healthy diets, following regular exercises, losing over weight, reducing the intake of salt/salty items and keeping all these suggestions together for maintaining a good health of your child, having high blood sugar.










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