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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
03:19

Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Published on: June 21, 2024

Update on imaging for suspected renovascular hypertension in children and adolescents

Stephen D Marks1, Kjell Tullus

  • 1Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. stephen.marks@gosh.nhs.uk

Current Hypertension Reports
|September 19, 2012
PubMed

Insights

Renovascular disease is a key consideration in children with high blood pressure, even with obesity. Early detection through advanced imaging can lead to effective treatment for these young patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Childhood obesity is increasing primary hypertension in developed nations.
  • Renovascular disease is a critical, yet often overlooked, cause of hypertension in children.
  • Identifying renovascular disease offers a treatable pathway for pediatric hypertension.

Purpose of the Study:

  • To investigate the prevalence and diagnostic approaches for renovascular disease in pediatric hypertension.
  • To highlight the importance of considering renovascular disease in children with uncontrolled hypertension.
  • To evaluate current imaging modalities for diagnosing renovascular disease.

Main Methods:

  • Review of diagnostic imaging techniques including Doppler renal ultrasonography, computed tomography angiography (CTA), and magnetic resonance angiography (MRA).
  • Emphasis on digital subtraction angiography as the gold standard for diagnosis.
  • Clinical identification criteria such as poor blood pressure control despite multiple medications or associated syndromes.

Main Results:

  • Advances in Doppler ultrasonography, CTA, and MRA have improved detection capabilities.
  • Digital subtraction angiography remains the definitive diagnostic tool.
  • Renovascular disease is a treatable cause of hypertension in pediatric patients.

Conclusions:

  • Renovascular disease should be actively investigated in children with difficult-to-control hypertension.
  • Digital subtraction angiography is crucial for both diagnosis and potential therapeutic intervention.
  • Timely diagnosis and treatment of renovascular disease can significantly improve outcomes in pediatric hypertension.

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