In children with CKD, what antihypertensive agents compared to standard of care improve efficacy outcomes and reduce adverse effects?
A Cochrane review by Bagga A et al. found that renin-angiotensin system (RAS) inhibitors, such as angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB), and aldosterone antagonists, as well as non-RAS inhibitors, such as alpha-blockers, beta-blockers, calcium channel blockers (CCBs), diuretics, and direct renin inhibitors (DRI), when compared to placebo or standard of care, can improve efficacy outcomes and reduce adverse effects in children with CKD. Outcomes measured include blood pressure, serum creatinine, and other critical and important outcomes listed in Supplementary Table S107. The review also noted that further research may be necessary due to uncertainties in the evidence including the population, interventions, and outcomes measured in the trials and their applicability to the clinical question. 