Dr Tammy Brady on Exciting Advances in Pediatric Nephrology

An increasing emphasis on prevention is shifting the mindset around pediatric nephrology, and findings from ongoing studies will further expand the evidence base, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Transcript

What have been the most significant recent discoveries or advances in pediatric nephrology?

So I think in regards to metabolic syndrome and cardiovascular health, really, I think the biggest thing has been this new idea of cardiovascular health promotion, and this concept of ideal cardiovascular health.

And in fact, with the new American Academy of Pediatrics clinical practice guidelines, I think this is a great example. I mean, this massive document details all of the evidence to support their recommendations for regular screening, early diagnosis, and treatment of pediatric hypertension, which really has promised to have a significant impact in the future health of our future adults.

The American Heart Association and other professional organizations also are pushing forward this concept, more prevention, so primordial prevention, meaning preventing the development of risk factors from ever becoming manifest in the first place, recognizing that there’s a life span approach to chronic disease and we really as pediatricians need to work early and hard at preventing these risk factors from ever developing.

I think this shift in mindset has really sparked a lot of really cool and interesting research that will move the field forward. I’m particularly excited to see the results of the SHIP-AHOY [Study of High Blood Pressure in Pediatrics: Adult Hypertension Onset in Youth] study, which is working to find what blood pressure, among other things, but what blood pressure thresholds really associate with intermediate outcomes in children, because right now, we’re using epidemiologic cutoffs to diagnose hypertension and manage treatment. And hopefully, this study will give us some more real evidence base as to what blood pressure thresholds we really should be targeting because that’s what’s going to have the most impact in terms of outcomes. So I think there’s been a lot of advances, but I think in the next 5 years, we’re going to be seeing even more exciting things coming through.