title: Reno-vascular hypertension in childhood: a nationwide survey.
abstract: Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension.
authors.affiliation: Department of Paediatric Nephrology, School of Medicine, Cukurova University, 01330, Balcali, Adana, Turkey. ayskar@yahoo.com
authors.forename: Aysun K
authors.initials: AK
authors.lastname: Bayazit
authors.forename: Fatos
authors.initials: F
authors.lastname: Yalcinkaya
authors.forename: Nilgun
authors.initials: N
authors.lastname: Cakar
authors.forename: Ali
authors.initials: A
authors.lastname: Duzova
authors.forename: Zelal
authors.initials: Z
authors.lastname: Bircan
authors.forename: Aysin
authors.initials: A
authors.lastname: Bakkaloglu
authors.forename: Nur
authors.initials: N
authors.lastname: Canpolat
authors.forename: Nazl
authors.initials: N
authors.lastname: Kara
authors.forename: Aydan
authors.initials: A
authors.lastname: Sirin
authors.forename: Mesiha
authors.initials: M
authors.lastname: Ekim
authors.forename: Ayse
authors.initials: A
authors.lastname: Oner
authors.forename: Sema
authors.initials: S
authors.lastname: Akman
authors.forename: Sevgi
authors.initials: S
authors.lastname: Mir
authors.forename: Esra
authors.initials: E
authors.lastname: Baskin
authors.forename: Hakan M
authors.initials: HM
authors.lastname: Poyrazoglu
authors.forename: Aytul
authors.initials: A
authors.lastname: Noyan
authors.forename: Ipek
authors.initials: I
authors.lastname: Akil
authors.forename: Sevcan
authors.initials: S
authors.lastname: Bakkaloglu
authors.forename: Alper
authors.initials: A
authors.lastname: Soylu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006306:Health Surveys; D006801:Humans; D006978:Hypertension, Renovascular / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014421:Turkey / Q000453:epidemiology