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Intrarenal aneurysm of the renal artery in children
Insights
Intrarenal aneurysms in children can cause renovascular hypertension. Treatment options like embolization or nephrectomy can effectively cure this condition, preserving kidney function.
Area of Science:
- Pediatric Nephrology
- Interventional Radiology
Background:
- Renovascular hypertension in children is often caused by renal artery abnormalities.
- Intrarenal aneurysms are an uncommon but significant cause of this condition.
Observation:
- Two pediatric cases presented with hypertension secondary to intrarenal aneurysms.
- Renal vein renin assays confirmed renovascular hypertension due to unilateral renin hypersecretion.
Findings:
- Successful treatment was achieved through transcatheter embolization of a segmental artery in one child.
- Nephrectomy provided a curative outcome for the other child with multiple aneurysms.
Implications:
- Intrarenal renal artery aneurysms require timely diagnosis and management in pediatric hypertension.
- Transcatheter embolization offers a minimally invasive, parenchyma-sparing alternative to surgery for solitary aneurysms.
Abstract:
Two children with hypertension had intrarenal aneurysms in the renal artery. In both children, renovascular hypertension was documented by renal vein renin assay showing elevated renin secretion from the involved kidney and suppression of renin secretion from the contralateral kidney. Transcatheter embolization of a segmental artery cured the hypertension in one case. A nephrectomy performed in the other case, because of multiple intrarenal aneurysms, was curative. Intrarenal renal artery aneurysms are an uncommon cause of renovascular hypertension in children. The aneurysms may be mycotic or congenital in origin, or secondary to diffuse vasculitis. Although spontaneous resolution of the aneurysms may occur when due to vasculitis, treatment of most aneurysms is usually necessary. Transcatheter embolization of solitary aneurysms is an attractive alternative to partial nephrectomy, since it allows maximal preservation of renal parenchyma with minimal morbidity.