[Renovascular hypertension in children].
Renovascular hypertension (RVH) is more commonly diagnosed in children than in adults. The prevalence of RVH in unselected hypertensive adults is < 1%, compared with 5-25% in children. The most common cause RVH in childhood is fibromuscular dysplasia, which is reported in 60% of patients, but in the neonatal period renal artery thrombosis after umbilical artery catheterization is the main cause of hypertension. Most of RVH children have no symptoms when an increased blood pressure is detected during routine examination. Special diagnostic procedures are allowed only when suspicion of RVH is based on history data, physical examination and laboratory analysis and other possible reasons of hypertension were excluded. The paper describes contemporary diagnostic methods and their usefulness in revealing RVH in children, depending on their age, location of abnormalities in renal arteries and their extent. The significance of angiotensin converting enzyme inhibition scintirenography in diagnosing of RVH in newborns and infants is exposed. Current therapeutic abilities, such as surgical procedures, percutaneous transluminal renal angioplasty and pharmacological treatment, are also shown. The attention is called to amelioration in effects after operations and PTRA. The stress is also put on resistance to conservative treatment and possible complications due to therapy. The necessity of individual therapy is underlined.
Zwolińska
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Katedry i Kliniki Nefrologii Pediatrycznej AM we Wrocławiu.
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005352:Fibromuscular Dysplasia / Q000453:epidemiology; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D014652:Vascular Diseases / Q000453:epidemiology