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Our purpose was to evaluate the effects of angiotensin II receptor type 1 antagonists (ARAs) in children and adolescents with hypertension or/and several kinds of nephropathies on blood pressure (BP) and proteinuria and to evaluate related safety issues. Data sources were Medline, Embase, The Cochrane Library, BIOSIS Previews, contact with investigators and manufacturers, personal bibliography of the lead author, and manual searches. We selected randomized controlled trials (RCTs), uncontrolled trials, and case series investigating ARAs in children and adolescents, as well as case reports about adverse events and the embryotoxic effects of ARAs in children. In four RCTs with 698 individuals, mean systolic blood pressure (BP) decreased by 10.5 mmHg [95% confidence interval (CI) 9.8-11.2] and mean diastolic BP by 6.4 mmHg (95% CI 5.8-7.0). Proteinuria decreased by 30-64% (range) in two RCTs and four case series. Safety data were comparable with adult safety data. ARAs can be considered effective and safe in lowering BP and proteinuria in the pediatric age group. The correlation between the surrogate parameters BP and proteinuria with clinical endpoints is documented to a large degree. The evidence is based on RCTs and also on lower evidence levels, such as case series. In some conditions, RCTs in children are not feasible. Registers could provide more evidence in the future.

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Kurzfassung Die Entwicklung von Industrie 4.0 stellt einen wichtigen Beitrag zur Neugestaltung von Produktionssystemen dar. Eine wichtige Grundlage zur Realisierung von Industrie 4.0 sind cyber-physische Systeme, die in der Lage sind, miteinander zu kommunizieren und zu kooperieren. Durch die Integration cyber-physischer Systeme in Produkt-Service Systeme können innovative Kombinationen von Sach- und Serviceprodukten im Sinne cyber-physischer Produkt-Service Systeme (PSS 4.0) realisiert werden. Dadurch können Sachprodukte verbessert und Serviceprodukte zielgerichtet an den Kundenbedürfnissen ausgerichtet werden. Ziel dieses Beitrags ist es, Einflüsse cyber-physischer Systeme auf Produkt-Service Systeme und den daraus resultierenden Mehrwert aufzuzeigen. Dazu werden eine allgemeingültige Definition von PSS 4.0 generiert und Anforderungen an die Gestaltung von PSS 4.0 abgeleitet.

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