. Author manuscript; available in PMC: 2010 Aug 1.

Published in final edited form as: Am J Kidney Dis. 2009 Aug;54(2):345–360. doi: 10.1053/j.ajkd.2009.04.027

Table 5.

Summary of Treatment Goals for CVD Risk Factors in Children With CKD

Risk factor	Goal	Reference
Hypertension	Blood pressure <90^th percentile for age, sex, and height, or <120/80mmHg, whichever is lower.	NKF KDOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease¹¹³ and the Fourth report on blood pressure in children¹¹⁴.
Dyslipidemia	Maintenance of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in age-appropriate ranges for high cardiovascular disease risk patients.	NKF KDOQI Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease¹¹⁵ & for Managing Dyslipidemias in Kidney Transplant Patients¹¹⁶ (note: these guidelines contain recommendations only for patients older than 13 years, with end-stage renal disease & transplant, respectively). For patients with stage 2–4 CKD, and those younger than 13 years, see clinical report by Daniels et al.¹¹⁷ for age-appropriate guidelines in high-risk patients.
Obesity & Physical Inactivity	Maintenance of normal body habitus (Body mass index between 5^th and 85^th percentile for age, sex).	NKF KDOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure¹¹⁸.
Hyperinsulinemia/Hyperglycemia	Maintenance of normoglycemia and normal insulin sensitivity.	No pediatric-specific guidelines exist.
Abnormal mineral metabolism	Phosphorous, Ca x P, and intact parathyroid hormone goals vary by age and CKD stage.	NKF KDOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Children with Chronic Kidney Disease¹¹⁹.
Anemia	Maintenance of hemoglobin in the range of 11.0 to 12.0gm/dL in patients receiving erythropoeisis stimulating agent (ESA) therapy, along with maintenance of adequate iron stores.	KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease¹²⁰.
LVH	Maintenance of normal left ventricular mass and function; in those patients with pre-existing left ventricular hypertension, normalization of echocardiographic findings.	KDOQI Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients¹²¹.

Abbreviations: NKF, National Kidney Foundation; KDOQI, Kidney Disease Outcomes Quality Initiative; LDL, low-density lipoprotein; HDL, high-density lipoprotein; CKD, chronic kidney disease; Ca x P, calcium-phosphorus product.