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[Hypertensive emergencies in children with renal hypertension (author's transl)]
Insights
Hypertensive emergencies in children with renal hypertension require prompt treatment. Diazoxide is the first-choice drug, though hyperglycemia can occur with repeated doses.
Area of Science:
- Pediatric Nephrology
- Hypertension Management
- Renal Disease in Children
Context:
- Analysis of 10 pediatric cases with hypertensive emergencies linked to renal hypertension.
- Identified underlying renal pathologies including chronic renal failure, acute renal failure, hemolytic uremic syndrome, post-streptococcal glomerulonephritis, and renal arterial stenosis.
Purpose:
- To analyze the characteristics and management of hypertensive emergencies in children with renal disease.
- To highlight the importance of early intervention and identify effective therapeutic agents.
Summary:
- Hypertensive emergencies in children stem from various renal conditions.
- Early symptoms like headache and vomiting signal the need for urgent therapy.
- Diazoxide is the primary recommended intravenous drug (3-5 mg/kg).
- Transient hyperglycemia was observed in three patients following repeated diazoxide administration.
Impact:
- Emphasizes the critical role of timely treatment initiation for pediatric hypertensive emergencies.
- Provides evidence for diazoxide as a first-line therapy while noting potential side effects.
- Informs clinical practice regarding the management of severe hypertension in pediatric renal disease.
Abstract:
Hypertensive emergencies of 10 children with renal hypertension were analysed. Cause of renal disease are chronic renal failure in three, acute renal failure in three, hemolytic uremic syndrome in two, acute post streptococcal glomerulonephritis in one, and renal arterial stenosis in a further patient. Therapy should be started early in the course of the hypertensive emergency, first symptoms are headache and vomiting. Drug of first choice is diazoxide (3-5-(8)mg/kg i.v.). Three patients developed transitory hyperglycemia after repeated injections of diazoxide.