Therefore, antibody titers should be checked several years after the vaccination and the patient should be re-vaccinated if necessary. If a child with nephrotic syndrome receives a dose of prednisolone (PSL) of >2 mg/kg/day, vaccination is not recommended since seroconversion is unlikely. Live vaccines are recommended for children with CKD in general, but they are not recommended for children with CKD undergoing adrenocorticosteroid or immunosuppressive treatment. As a general rule, these patients should not be vaccinated until 3 months after terminating
their immunosuppressive treatment. However, patients who are taking an immunosuppressant might be vaccinated if they reside in a region considered to be particularly high risk. For CKD in children undergoing adrenocorticosteroid therapy, Selleck PND-1186 vaccinations should be withheld until the dose of PSL is lower than 1 mg/kg/day or 2 mg/kg/every other day. Bibliography 1. Prelog M, et al. Pediatr AZD0530 Transplant. 2007;11:73–6. (Level 4) 2. Broyer M, et al. Pediatrics. 1997;99:35–9. (Level 4) 3. Mori K, et al. Pediatr Int.
2009;51(5):617–20. (Level 4) 4. Mahmoodi M, et al. Eur Cytokine Netw. 2009;20:69–74. (Level 4) 5. Liakou CD, et al. Vaccine. 2011;29:6834–7. (Level 3) 6. Zamora I, et al. Pediatr Nephrol. 1994;8:190–2. (Level 4) Is antihypertensive drug therapy recommended for children with CKD to inhibit the progression of kidney dysfunction? Hypertension is one of the
most common sequelae of children with CKD and it is prevalent only in the earlier stages of CKD. Hypertension is the highest risk factor for the progression of renal Tanespimycin manufacturer insufficiency and CVD. 1. Antihypertensive drug therapy and children with CKD The ESCAPE Trial of 385 children with CKD (GFR between 15 and 80 mL/min per 1.73 m2) reported that strict blood pressure (BP) control slows the progression of renal insufficiency and that the renoprotective effect of intensified BP control added to the potential benefit conferred by ACE inhibition. Therefore we recommend why antihypertensive drug therapy for the treatment of children with CKD stage 2–4 because it inhibits the progression of renal insufficiency. 2. Antihypertensive agents for children with CKD Clinical studies have suggested that ACE inhibitors and ARBs are effective in reducing proteinuria and inhibiting the progression of CKD. Therefore we suggest that RAS inhibitors, including ACE inhibitors and ARBs, be the first choice for treating hypertension in children with proteinuric CKD. Calcium channel blockers are useful as add-on therapy in children with resistant hypertension. The physician should select the antihypertensive agent according to the symptoms, because there is no conclusive evidence as to whether the inhibition of the renin–angiotensin system is superior to other antihypertensive agents in non-proteinuric CKD patients.