What is the role of antihypertensive therapy in the treatment of pediatric nephrotic syndrome?

Updated: Mar 04, 2020
  • Author: Jerome C Lane, MD; Chief Editor: Craig B Langman, MD  more...
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Antihypertensive therapy should be given when hypertension is present and particularly if it persists, but caution should be exercised. In some patients, the hypertension will respond to diuretics. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) may also contribute to reducing proteinuria but should be used cautiously in the presence of acute kidney failure or volume depletion because they can worsen kidney function in these settings.

Because ACE inhibitors and ARBs can cause birth defects, adolescent women who are taking these agents must be counseled regarding the use of birth control, and pregnancy testing should be considered before starting these agents.

Calcium channel blockers and beta-blockers may also be used as first-line agents for hypertension.

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