Nonrenovascular renal hypertension in children

Hypertension in children has been reported with increasing frequency because of increased awareness of its occurrence by clinicians. Renovascular lesions have been stressed in the past. However, in recent years, a number of nonrenovascular renal lesions have received attention and form the basis for this report. Unilateral chronic atrophic pyelonphritis, segmental unilateral pyelonephritis, the Ask-Upmark kidney, and unilateral renal hypoplasia have been associated with curable hypertension. The subject of juxtaglomerular cell hyperplasia, which has variably been reported in these cases, is reviewed. Ureteral obstruction, in the form of uretero-pelvic or ureterovesical junction obstruction, solitary renal cysts, the unilateral multicystic kidney, renal trauma, and renal tumors (Wilms' tumor and juxtaglomerular cell tumors) may also be associated with hypertension in children. Pheochromocytoma must be ruled out in all cases. Because of renewed interest, these nonrenovascular renal causes of hypertension are now likely to be diagnosed with increased frequency.