PKD Life - Summer 2020 - 8

Ages & Stages

THE KID ZONE

Living With
Hypertension
How PKD affects blood
pressure in children-and
what parents can do to help.

a slight buzz on the wrist from their
WatchMinder3 watches. The vibration
reminds Jaina, 9, and Chesley, 5, to drink
water-one way they combat their
high blood pressure. Both girls have
autosomal recessive PKD (ARPKD).
"Almost all patients with ARPKD
develop high blood pressure in their
childhood," says Laurel K. Willig, M.D.,
a pediatric nephrologist at Children's
Mercy in Kansas City, Missouri, and
an associate professor of pediatrics at
the University of Missouri-Kansas City
School of Medicine. By contrast, only
30% to 40% of those with the more
common autosomal dominant PKD
(ADPKD) develop it.
Exactly why blood pressure rises in
ARPKD and ADPKD is not entirely clear,
Dr. Willig says. "A leading theory is
that cyst formation disrupts blood flow
around the kidneys," she says. "When
there's a restriction of blood supply to
the kidney tissues, it leads to hormonal
changes, causing increased blood pressure. Additionally, these hormonal
changes may play a role in causing more
cysts to form, creating a vicious cycle."
Whatever the mechanisms, managing blood pressure in young people with
PKD is essential to minimizing acute

PKD LIFE * SUMMER 2020

See a nutritionist.
A low-salt diet lowers blood pressure,
but kids need salt to
grow. A nutritionist
can help you plan
meals to get the
right balance.
Make water
intake a priority.
Lisa Cormack says
her kids take colorful water bottles
with them every
day and sip when
their watches
prompt them.
Monitor his or
her medications
carefully. "If a child
is missing pills, it's hard
to tell if they're on the
right dosage," says
Laurel K. Willig, M.D.
Ask about
ambulatory blood
pressure tests. The
gold standard for
diagnosing blood
pressure problems
is to wear a cuff
continuously for
24 hours, Dr. Willig
says. Kids younger
than 5 usually don't
qualify for the test,
but older children do.

complications. These include seizures
and strokes-which are rare-and more
common chronic complications such
as significant cardiovascular disease
and faster progression of renal disease,
Dr. Willig says.
Kids with high blood pressure usually
take the same medications as adults:
either ACE inhibitors or angiotensin II
receptor blockers (ARBs), which widen
and relax blood vessels and decrease
blood volume to lower blood pressure.
But Dr. Willig says monitoring hypertension in kids can often be more difficult because they can be uncooperative
when it comes to measuring their
pressure. Some children may also have
trouble swallowing pills or complying
with medication schedules.

ALEXANDRA RIBEIRO/EYEEM/GETTY IMAGES

every 30 minutes, Lisa
A bout
Cormack's two daughters feel

If Your Child Has High Blood Pressure

By Andrea Atkins

PKD Life - Summer 2020

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