In children with CKD, does a lower BP target compared to a higher BP target improve efficacy outcomes and reduce adverse effects?
The evidence from randomized controlled trials suggests that lower blood pressure targets are associated with improved efficacy outcomes and reduced adverse effects in children with CKD. In a Cochrane review, Natale et al. (2020) found that lower blood pressure targets were associated with improved clinical endpoints such as decreased progression to end-stage renal disease, decreased proteinuria, improved glomerular filtration rate, and improved renal function. They also found that lower blood pressure targets were associated with reduced adverse effects such as decreased risk of stroke and cardiovascular events. However, further research is needed to assess the long-term benefits and harms associated with lower blood pressure targets in this population.