title: Associated extrarenal vascular diseases may complicate the treatment and outcome of renovascular hypertension.
abstract: OBJECTIVE
  This studied reviewed renovascular hypertension (RVH) due to renal artery stenosis (RAS) in two Serbian paediatric centres from 2001 to 2013.
  
  
  METHODS
  The patients' demographic data, underlying syndromes, blood pressure (BP), antihypertensive treatments and outcomes were reviewed.
  
  
  RESULTS
  The incidence of RVH was 1.9 per million children per year during the study period, and there were 25 patients with RAS, aged 10.4 ± 5.2 years. At presentation, their mean blood pressure (BP) standard deviation scores were 6.9 ± 3.4 systolic and 5.2 ± 2.6 diastolic. BP loads on 24-hour ambulatory BP were 88 ± 14% systolic and 80 ± 29% diastolic. We found that 72% had fibromuscular dysplasia and 28% had underlying syndromes. RAS was unilateral in 64% and bilateral in 28%, and 8% had RAS of a single kidney. Antihypertensive treatment included antihypertensive drugs (100%), percutaneous transluminal angioplasty (92%), renal auto-transplantation (16%), surgical revascularisation (12%) and nephrectomy (12%). After 4.4 ± 3.6 years of follow-up, high BP was cured in 40% of the patients and 39.4% of the kidneys and improved in 48% (75.7%), with BP decreases of 20.3 ± 3.7% systolic and 16.3 ± 6.2% diastolic.
  
  
  CONCLUSIONS
  Fibromuscular dysplasia was the most common cause of RVH in this study, and hypertension was cured or improved in 88% of the patients.
authors.affiliation: Medical School of University of Belgrade, Belgrade, Serbia.|Nephrology Department, University Children's Hospital, Belgrade, Serbia.
authors.forename: Amira
authors.initials: A
authors.lastname: Peco-Antić
authors.affiliation: Department of Nephrology, Institute of Mother and Child Health Care of Serbia 'Dr Vukan Ćupić', Belgrade, Serbia.
authors.forename: Nataša
authors.initials: N
authors.lastname: Stajić
authors.affiliation: Medical School of University of Belgrade, Belgrade, Serbia.|Urology Department, University Children's Hospital, Belgrade, Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Krstić
authors.affiliation: Medical School of University of Belgrade, Belgrade, Serbia.|Department of Nephrology, Institute of Mother and Child Health Care of Serbia 'Dr Vukan Ćupić', Belgrade, Serbia.
authors.forename: Radovan
authors.initials: R
authors.lastname: Bogdanović
authors.affiliation: Nephrology Department, University Children's Hospital, Belgrade, Serbia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Miloševski-Lomić
authors.affiliation: Medical School of University of Belgrade, Belgrade, Serbia.|Cardiology Department, University Children's Hospital, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Đukić
authors.affiliation: Nephrology Department, University Children's Hospital, Belgrade, Serbia.
authors.forename: Dušan
authors.initials: D
authors.lastname: Paripović
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D009392:Nephrectomy; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Arterial hypertension; Children; Fibromuscular dysplasia; Percutaneous transluminal angioplasty; Renal artery stenosis