[Clinical characteristics and imaging evaluation in children with renovascular hypertension].
OBJECTIVE
To characterize the clinical and angiographic features in children with renovascular hypertension.


METHODS
Clinical data of 14 children (7 male, 7 female; age 0.8-14 years, mean 8.7 years), who were diagnosed with renovascular hypertension by renal angiography in our institute from January 2005 to December 2012 were collected and retrospectively analyzed.


RESULTS
The mean blood pressure at the diagnosis was 187/127 mm Hg. Chief complaints of symptomatic patients were headache (29%, 4/14), hypertensive encephalopathy (36%, 5/14), signs of congestive heart failure (14%, 2/14) and hematemesis (7%, 1/14). Renovascular hypertension was found incidentally in 14% (2/14) of patients who were asymptomatic. Conventional renal angiography elucidated the anatomical distribution of lesions in the renal arterial system. It was found that 14% (2/14) of patients had bilateral disease, 50% (7/14) had single stenosis at main or accessory renal artery, while multiple stenoses was seen in 43% (6/14) of children, with involvement of segmental renal artery and small interlobar or arcuate vessels. Compared with catheter angiography, 50% (7/14) of patients with renovascular hypertension, especially intrarenal arterial disease, were missed on computed tomography angiography or magnetic resonance angiography.


CONCLUSIONS
It is mandatory to emphasize blood pressure measurement in pediatric clinical practice for early recognition of renovascular hypertension. As children with renovascular hypertension display involvement of multiple arteries, including in smaller intrarenal arteries, digital subtraction angiography is the only method that can reliably diagnose pediatric renovascular hypertension.
Catheterization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai.
Ying
Y
Lu
Lin
L
Wu
Fang
F
Liu
Xi-hong
XH
Hu
Chun-hua
CH
Qi
Lan
L
He
Guo-ying
GY
Huang
D000293:Adolescent; D015901:Angiography, Digital Subtraction; D002648:Child; D002675:Child, Preschool; D005260:Female; D005352:Fibromuscular Dysplasia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed