Published online Nov 6, 2015. doi: 10.5527/wjn.v4.i5.500
Peer-review started: May 29, 2015
First decision: August 4, 2015
Revised: August 30, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: November 6, 2015
Core tip: Hypertension (HTN) is often difficult to control in chronic kidney disease (CKD). Failure to achieve the desired therapeutic BP target in the hypertensive CKD child could be due to comorbidities and toxic effects of HTN promoting medications. So, before starting or altering anti-hypertensive medications, it is important that patients are evaluated for the roles that HTN promoting medications and co-morbidities like chronic anaemia, hyperphosphataemia, progressive tunica media calcifications, and serum parathyroid hormone levels that are well above the acceptable limits for CKD stage could be playing in the entire process. Ways of solving this important clinical problem are the focus of this article.