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A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Renovascular hypertension
1Pediatric Nephrology Unit, Department of Pediatrics, Command Hospital, Pune 411 040, India. madhurikanitkar@rediffmail.com
Insights
Renovascular hypertension, caused by kidney blood flow blockages, affects 3-10% of children with severe hypertension. Early diagnosis and treatment of renovascular lesions are crucial for managing this correctable condition.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Medicine
- Diagnostic Imaging
Background:
- Renovascular hypertension stems from lesions impairing renal blood flow, affecting 3-10% of pediatric hypertension cases.
- It is the second leading cause of correctable hypertension in children, after coarctation of the aorta.
Purpose of the Study:
- To highlight the importance of systematic evaluation for identifying children with renovascular hypertension.
- To discuss diagnostic investigations and therapeutic options for renovascular hypertension in children.
Main Methods:
- Review of diagnostic modalities for renovascular hypertension, including invasive (renal arteriography) and non-invasive techniques (Doppler ultrasonography, CT/MR angiography).
- Discussion of therapeutic interventions such as angioplasty, stenting, and surgical revascularization.
Main Results:
- Renovascular lesions are found in a significant percentage of children evaluated for severe hypertension.
- Non-invasive imaging techniques offer alternatives to invasive procedures like renal arteriography.
Conclusions:
- Systematic evaluation aids pediatricians in selecting children likely to have renovascular hypertension, minimizing exposure to invasive diagnostics.
- Available therapeutic options justify the diagnostic workup for renovascular hypertension, with interventions including angioplasty, stenting, and surgery.
Abstract:
Renovascular hypertension results from a lesion that impairs blood flow to a part or all, of one or both kidneys. 3-10% of children referred for the evaluation of severe hypertension are subsequently found to have clinically significant renovascular lesions Renovascular hypertension is the second most common cause of correctable hypertension in children second only to coarctation of the aorta. Specific therapeutic options now available, justify the often-invasive investigations required to confirm the diagnosis of renovascular hypertension. A systematic evaluation of the child with hypertension will help the pediatrician select correctly, the child most likely to have renovascular hypertension, thus reducing the number of children exposed to the risks involved with diagnostic but invasive investigations like renal arteriography which remains the gold standard Other non-invasive newer modalities like doppler ultrasonography, computed duplex sonography, ACE inhibited radionuclide imaging, and MR/CT/spiral CT angiography may be used depending on the availability of the facilities. Definite therapeutic options for renal artery stenosis include angioplasty, stenting and surgical re-vascularization using a bypass graft.
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