1. Associated extrarenal vascular diseases may complicate the treatment and outcome of renovascular hypertension
- Author
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Gordana Milosevski-Lomic, Natasa Stajic, Radovan Bogdanovic, Amira Peco-Antic, Milan Đukić, Dusan Paripovic, and Zoran Krstic
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Diastole ,Renal Artery Obstruction ,Fibromuscular dysplasia ,030204 cardiovascular system & hematology ,Renal artery stenosis ,Nephrectomy ,030218 nuclear medicine & medical imaging ,Renovascular hypertension ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Fibromuscular Dysplasia ,Humans ,Child ,Antihypertensive Agents ,Kidney transplantation ,Retrospective Studies ,business.industry ,General Medicine ,medicine.disease ,Combined Modality Therapy ,Kidney Transplantation ,3. Good health ,Hypertension, Renovascular ,Treatment Outcome ,Blood pressure ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,business ,Serbia ,Follow-Up Studies - Abstract
Aim 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. Conclusion Fibromuscular dysplasia was the most common cause of RVH in this study, and hypertension was cured or improved in 88% of the patients.
- Published
- 2015