Hypertension management in pediatric peritoneal dialysis: A scoping review

Abstract

BackgroundPeritoneal dialysis (PD) is a prominent treatment option for children with kidney failure. However, cardiovascular disease remains the leading cause of both morbidity and early mortality in this pediatric population, with 50-70% of patients experiencing hypertension. This scoping review aims to assess pediatric hypertension management among those receiving PD, along with exploring new potential techniques to optimize care.MethodsPubMed and Web of Science were used to conduct a literature search using PRISMA-ScR guidelines. The topic was hypertension management in PD in the pediatric population. Studies within the last 10 years that were written in English were included to capture the latest advancements in the literature. Six articles were included in the review.ResultsThe included articles illustrated 3 main management strategies, which were diet, fluid volume, and antihypertensive drugs. More specifically, an inverse relationship between vitamin D and cholesterol levels and a lack of correlation between simple salt balance and hypertension have been described. Bioimpedance spectroscopy and B-type natriuretic peptide were found to be useful in the estimation of fluid volume. Additionally, the persistence of hypertension was found despite the use of antihypertensive drugs.ConclusionsThe presenting studies reflect the uncertainty of the current evidence available on hypertensive treatments in this population. Thus, our findings may help guide further research until the evidence is sufficient for clinical recommendations.