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Selective renal embolisation for renovascular hypertension?
M V Ognjanovic1, D Richardson, M de La Hunt
1Department of Nephrology, Mother and Child Health Institute, Belgrade, Yugoslavia. malcolm.coulthard@ncl.ac.uk
Archives of Disease in Childhood
|February 6, 2002
Summary
Reflux nephropathy can cause severe hypertension and kidney failure in children. A heminephrectomy effectively controlled hypertension in a young patient, suggesting it as a definitive treatment option.
Area of Science:
- Pediatric Nephrology
- Hypertension Management
- Renal Surgery
Background:
- Reflux nephropathy is a significant cause of pediatric hypertension and renal failure.
- Management strategies for severe cases remain a clinical challenge.
Observation:
- An 11-year-old girl presented with hypertensive encephalopathy and renal failure secondary to reflux nephropathy.
- Initial management included left kidney resection, which failed to control hypertension.
Findings:
- Selective arterial embolization of the right kidney provided only temporary hypertension control.
- A subsequent right heminephrectomy resulted in sustained blood pressure normalization.
- This case highlights the effectiveness of heminephrectomy in managing refractory hypertension due to reflux nephropathy.
Implications:
- Heminephrectomy can be a definitive treatment for hypertension in pediatric reflux nephropathy.
- Arterial embolization might offer transient relief but may delay definitive surgical intervention.