What is the evidence for the recommendation to lower BP in children with CKD?
The evidence for this recommendation comes largely from the ESCAPE trial which showed a benefit in slowing CKD progression by targeting 24-hour MAP by ABPM to less than percentile for age, height and sex. Secondary analysis of the data suggested the effect was stronger in proteinuric children with CKD. The European Society of Hypertension guidelines recently recommended that in children with CKD, BP targets should be below the 50th percentile in the presence of proteinuria and below the 75th percentile in the absence of proteinuria.