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Long-Term Outcomes of Pediatric Renovascular Hypertension
Hyun Chung1, Jae Hwan Lee2, Eujin Park1
1Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.
Insights
Aggressive treatment for pediatric renovascular hypertension (RVHT) showed fair outcomes. However, cerebrovascular disease (CVD) comorbidity was linked to poorer percutaneous transluminal angioplasty (PTA) results in children.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Research
- Hypertension Management
Background:
- Renovascular hypertension (RVHT) is a significant cause of hypertension in children.
- Understanding the clinical characteristics and treatment outcomes of pediatric RVHT is crucial.
Purpose of the Study:
- To evaluate the clinical features and treatment outcomes of Korean children diagnosed with RVHT.
- To identify factors influencing treatment success in pediatric RVHT.
Main Methods:
- Retrospective review of children treated for RVHT between 2000 and 2015.
- Analysis of outcomes following percutaneous transluminal angioplasty (PTA) and surgical interventions.
- Comparison of kidney atrophy rates between PTA and medication groups.
Main Results:
- Clinical benefit was observed in 53.3% of children post-treatment.
- Patients with comorbid cerebrovascular disease (CVD) had less favorable PTA outcomes and higher restenosis rates.
- PTA was associated with lower rates of kidney atrophy compared to medication alone.
Conclusions:
- Aggressive management of pediatric RVHT can yield fair outcomes.
- CVD comorbidity negatively impacts PTA outcomes in pediatric RVHT.
- Larger cohort studies are needed to validate these findings.
Background/Aims:
Renovascular hypertension (RVHT) is an important cause of childhood hypertension. This study evaluated the clinical characteristics and outcomes of Korean children with RVHT.
Methods:
Children treated for RVHT between 2000 and 2015 at our center were retrospectively reviewed.
Results:
Forty-six children were followed for a median of 6.5 (0.66-27.23) years. Forty-five percutaneous transluminal angioplasties (PTAs) were performed in 32 children. At the last visit, clinical benefit was observed in 53.3% of children. Patients with comorbid cerebrovascular disease (CVD) showed less favorable long-term outcomes after PTA (clinical benefit in 41.7% vs. 61.1% in others) and higher restenosis rates (50% vs. 31.6% in others). Surgical procedures (bypass or nephrectomy) were performed in 8 patients. After surgery, blood pressure was normalized in 2 patients, improved in 3 patients, and unchanged in the remaining patients. Between PTA group (n=21) and medication group (n=14), percentage of atrophic kidneys became higher after follow-up period in medication group than in PTA group (60.0% vs. 26.1%, P=0.037).
Conclusion:
Aggressive treatment of pediatric RVHT yielded fair outcomes in our cohort. CVD comorbidity was associated with relatively poor PTA outcomes. To confirm our findings, larger cohort studies with a longer follow-up period are warranted.
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