Hypertension (HT) is one of the major problems in chronic kidney disease (CKD), not only for adults, but also
for children. It is one of the main factors in the progression of CKD, increased rate of cardiovascular disease, and
impairment in quality of life. The most important devastating effect of HT is on the cardiovascular system. It may leave
significant footprints in developing children that can be carried over to adulthood. Existing data clearly show that in CKD
children with proteinuria the blood pressure goal should be 50th centile, while it is 75th centile in those without
proteinuria. Renin-angiotensin system inhibitors are considered the first choice pharmacological option in hypertensive
CKD stage 2 to 4 patients. However, in clinical practice, pediatric nephrologists may experience significant problems in
treatment and follow-up of these patients, especially in compliance. Due to multiple drug use, physician-patient and
family cooperation would be essential to improve the compliance. Remembering the fact that prevention is always cheaper
than treatment, we need early detection of CKD and its devastating complications, like HT. Therefore, active screening
programs should be encouraged in children, as well as trying to find new biomarkers, inspired from the footprints of HT.
Although the researches on new urinary biomarkers for early detection of CKD and HT are promising, more studies are
needed in this area. This review aims to give an overview of HT in CKD children, mainly focusing on importance of HT,
basic principles of treatment, problems in follow up, and possible markers for early detection of CKD and HT.