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Hypertension is common among both peritoneal and hemodialysis patients. It is an important modifiable condition, and one of the most important contributors to the excess morbidity and mortality in this population. Accurate diagnosis with appropriate blood pressure measurement, especially with the use of ambulatory blood pressure monitoring, is crucial in order to achieve optimal blood pressure control. Achievement of dry weight during dialysis and avoidance of excessive interdialytic weight gain are the most important therapeutic strategies. When hypertension persists despite the achievement of euvolemia, antihypertensive medications may be required, and in some patients, native kidney nephrectomies.

Renal disorders associated with Turner syndrome (TS) are most often congenital anatomical anomalies of the kidneys and/or urinary tract (UT). Recently published studies have reported that approximately one-third of TS patients have such anomalies. The first half of this chapter will discuss these renal and UT anomalies and will provide a framework for screening, diagnosing, and managing these disorders. The second half of this chapter will discuss systemic hypertension (HTN), which is significantly more common in TS females compared to age-matched controls. Hypertension related to aortic coarctation is discussed in detail in chap. 6 and will only be briefly mentioned herein.

Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is a safe and effective tool for evaluating blood pressure (BP) in the pediatric population. ABPM has been shown to be better correlated with end-organ damage such as left ventricular hypertrophy (LVH) than casual BP measurements in pediatrics. It has specific benefits in certain patient populations, such as children with secondary hypertension, chronic kidney disease (CKD), diabetes, and patients who have had kidney transplants or are on dialysis. In addition, ABPM allows for diagnosis of white coat hypertension and masked hypertension, which is not possible with casual BP measurement. There are some limitations for using ABPM in children, such as the generalizability of the accepted normative data and how younger children will tolerate wearing the device. Despite these limitations, ABPM has been increasingly recommended for evaluating blood pressures in children, and as more data is gathered, we expect that it will be an even more effective tool in the diagnosis and management of pediatric hypertension.