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Hypertension in infancy: the case for aggressive management
The Journal of Urology
|April 1, 1975
Insights
Infants with hypertension often have renovascular causes. Medical management had a high mortality rate, while surgical intervention offered better survival outcomes for these young patients.
Area of Science:
- Pediatrics
- Nephrology
- Cardiology
Background:
- Infantile hypertension is a rare but serious condition.
- Renovascular causes are frequently implicated in pediatric hypertension.
- Early diagnosis and effective management are crucial for infant outcomes.
Purpose of the Study:
- To investigate the causes and outcomes of hypertension in infants.
- To evaluate the efficacy of medical versus surgical management for renovascular hypertension in neonates.
Main Methods:
- Retrospective case series of 10 infants under 3 months old with hypertension.
- Diagnosis of renovascular hypertension was confirmed in the majority of cases.
- Treatment strategies included medical management and surgical nephrectomy.
Main Results:
- Renovascular hypertension was diagnosed in 80% of the infants.
- Medical management resulted in spontaneous recovery in 30% but a 57% mortality rate.
- Surgical nephrectomy in 3 patients led to normotensive survival in 2.
Conclusions:
- Renovascular disease is a primary cause of hypertension in young infants.
- Medical management carries significant risks, with high mortality.
- Nephrectomy can be a life-saving intervention for selected infants with severe renovascular hypertension.
Abstract:
We have reported on 10 infants less than 3 months old with hypertension. Renovascular hypertension was identified in 80 per cent of these patients. Spontaneous recovery with medical management occurred in 30 per cent of the patients and 57 per cent treated medically died. Of the 3 patients treated by nephrectomy normotensive survival resulted in 2.