Renal artery stenosis in infants: long-term medical treatment before surgery.
This report describes five infants (3 male, 2 female) with renal artery stenosis diagnosed in their 1st year of life. The age at initial presentation was 5 days to 10 months. All had symptoms of congestive heart failure, cardiomegaly on chest X-ray, and left ventricular hypertrophy by electrocardiogram or echocardiogram. Renograms were abnormal in four of the five infants. An intravenous pyelogram was obtained in three infants and was abnormal in two. Renal ultrasounds were obtained in two infants and were normal in both. Patients were treated for 4.4 +/- 0.9 years with antihypertensive drug therapy until surgical correction of the renal artery stenosis. Blood pressure was persistently elevated above the 95th percentile in four of the infants during the course of antihypertensive therapy prior to surgery. Patients have been followed for 9.4 +/- 2 years since surgery. The blood pressure of four patients is normal, and the blood pressure of the oldest patient (age 23 years) is borderline hypertensive. These data show that infants with renal artery stenosis can be cared for successfully with long-term antihypertensive drug therapy to preserve renal mass with minimal chronic adverse effects.
Bendel-Stenzel
M
M
Department of Pediatrics, University of Minnesota Medical School, Minneapolis 55455, USA.
Najarian
J S
JS
Sinaiko
A R
AR
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D002216:Captopril / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006977:Hypertension, Renal / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007223:Infant; D008297:Male; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014567:Urography; D014656:Vascular Surgical Procedures
D000959:Antihypertensive Agents; D002216:Captopril