title: Renal artery revascularisation can restore kidney function with absent radiotracer uptake.
abstract: BACKGROUND
  Children with renovascular hypertension often present with severe hypertension. Some children have severe obstruction of their renal arteries resulting in <10% relative function on [(99m)Tc]dimercaptosuccinic acid (DMSA) scan. Conventional treatment of these children has been nephrectomy of the poorly functioning kidney to normalise their blood pressure (BP).
  
  
  METHODS
  We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery.
  
  
  CONCLUSIONS
  These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
authors: Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. yincent@doctors.net.uk.
authors: Yincent
authors: Y
authors: Tse
authors: Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
authors: Stephen D
authors: SD
authors: Marks
authors: Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
authors: Eileen
authors: E
authors: Brennan
authors: Department of Vascular Surgery, Royal Free Hospital, London, UK.
authors: George
authors: G
authors: Hamilton
authors: Department of Radiology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
authors: Clare A
authors: CA
authors: McLaren
authors: Department of Radiology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
authors: Derek J
authors: DJ
authors: Roebuck
authors: Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
authors: Kjell
authors: K
authors: Tullus
mesh_terms: D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D002648:Child; D002675:Child, Preschool; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007223:Infant; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D055420:Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D020127:Recovery of Function; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012079:Renal Circulation; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid