For a pediatric patient with Proteinuria, the protein in the kidney, going through the kidneys, and being lost through the kidneys damages them and accelerates the damage to the kidneys. That can be treated with ACE and ARB inhibitors, pediatricians should consider discussing this with their local nephrologist. Low blood pressure is a challenge because unlike other forms of kidney disease Fabry Disease is often not associated with high blood pressure. Renal insufficiency and high grade proteinuria are rare in children but if they occur pediatricians will want to treat them. Renal failure has been reported in some pediatric patients, and patients with the disease are candidates for dialysis and renal transplantation although the goal is to prevent that need. If high grade proteinuria is found in a pediatric patient with Fabry Disease, they need to evaluate for other causes, and it is likely that a renal biopsy would be a part of that evaluation.