“…Hypertension, which is present in~80-85 % of CKD patients [4,5], is a powerful indicator of CVD and an independent risk factor for disease progression both in adult and in pediatric patients with CKD [5,7]. Several mechanisms have been implicated in the pathogenesis of hypertension and CVD in CKD, including sodium retention and fluid overload due to defects in the pressure natriuresis relationship, activation of the renin-angiotensinaldosterone system (RAAS) [8,9,10•], sympathetic nervous system (SNS) hyperactivity [9, 11, 12••, 13••], autonomic dysfunction [13••, 14, 15], endogenous and environmental stress [5,16], impaired endothelial function, vascular remodeling, and arterial calcification [17,18], thus highlighting a complex interplay of neural, hormonal, and vascular mechanisms linking kidney disease to high blood pressure (BP) and the associated cardiovascular problems that consequently arise.…”