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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 in children
Kjell Tullus1, Eileen Brennan, George Hamilton
1Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK. tulluk@gosh.nhs.uk
Lancet (London, England)
|April 29, 2008
Summary
Renovascular disease, a rare cause of pediatric hypertension, often faces diagnostic delays. Prompt intervention, including endovascular procedures or surgery, can effectively manage high blood pressure in children.
Area of Science:
- Pediatric Nephrology
- Vascular Medicine
- Cardiology
Background:
- Renovascular disease is an uncommon yet significant cause of hypertension in children.
- Delayed diagnosis is frequent due to infrequent blood pressure monitoring and dismissal of high readings in pediatric patients.
- Associated abnormalities in other major blood vessels are common in children with renovascular disease.
Purpose of the Study:
- To summarize the diagnostic and therapeutic approaches for renovascular disease in children.
- To highlight the importance of early detection and multidisciplinary management.
- To review the effectiveness of current treatment modalities.
Main Methods:
- Review of diagnostic imaging techniques including CT, MRI, and renal scintigraphy with angiotensin-converting-enzyme inhibition.
- Angiography as the gold standard for diagnosis.
- Discussion of interventional and surgical treatment options.
Main Results:
- Endovascular treatment, with or without stenting, successfully cures or reduces hypertension in over 50% of affected children.
- Surgical intervention is recommended when necessary, ideally delayed until skeletal maturity.
- Multidisciplinary team management leads to favorable long-term outcomes.
Conclusions:
- Early recognition and timely intervention are crucial for managing pediatric renovascular hypertension.
- Both endovascular and surgical treatments offer significant benefits.
- A collaborative approach involving pediatric nephrologists, interventional radiologists, and vascular surgeons optimizes long-term results.
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