Renovascular hypertension in children- a rare pathology

Introduction: Secondary renovascular hypertension is a rare disease in children. For complete diagnosis, the patients with renovascular hypertension require a large number of investigations (renal ultrasound, renal Doppler ultrasound, abdominal CT angiography, renal arteriography and biological investigations). The therapeutic solutions are different depending on the degree of impaired renal function. Methods: Lot of 5 patients (3 males) admitted between October 2012 – March 2014 in the Department of Pediatric Cardiology Institute of Cardiovascular Diseases ,,Prof. dr. C. C. Iliescu”. The mean age at diagnosis was 9 years and 7 months. In all pts were done: clinical exam, ECG, creatinine cleareance, echocardiography, renal scintigraphy, renal angio CT and renal arteriography. Results: Resting systolic BP values were increased on average by 15 mm Hg compared to the 95th percentile for age and sex and by 6 mm Hg diastolic. Mean creatinine cleareance (Cockroft -Gault) – about 108 ml/ minute. Concentric hypertrophy of the LV wall with posterior wall 5.8 mm/m2 average body size and interventricular septum 6,9 mm/m2 body size. Plasma renin was elevated in all patients. Four of the patients had renal scintigraphy performed, all showing defi cits of capture. Four of the patients had renal arteriography performed: 2 pts, polar hypoplastic or stenotic artery, 1 pt intrarenal arterial stenosis of a branch, 1 pt unilateral renal right artery occlusion, 1 pt bilateral renal artery stenosis. Conclusions: Renovascular hypertension in children is most commonly secondary to congenital malformations of renal artery. Kidney function is oft en preserved. High blood pressure and increased plasma renin raise suspicion for diagnosis. Renal arteriography or angio CT are required for diagnosis.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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