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Pediatric hypertension as a delayed sequela of reflux-induced chronic pyelonephritis
Insights
Chronic pyelonephritis can cause hypertension, often renin-mediated, even after surgery. Removing scarred kidney tissue may improve high blood pressure, but caution is advised for patients with poor kidney function.
Area of Science:
- Nephrology
- Urology
- Cardiology
Background:
- Chronic pyelonephritis, often stemming from vesicoureteral reflux, is an occasional cause of systemic hypertension.
- This hypertension can manifest with or without active bacterial urinary infection and is renin-mediated.
- Hypertension may emerge years post-ureteral reimplantation surgery.
Abstract:
Chronic pyelonephritis secondary to vesicoureteral reflux has been shown to cause occasionally systemic hypertension. The hypertension may occur in the presence or absence of bacterial urinary infection, is renin-mediated and may develop years after ureteral reimplantation. Surgical excision of a scarred atrophic renin-producing segment may result in amelioration of the hypertension or at least provide better medical control with less toxic antihypertensive agents. Surgical removal of renal tissue is not recommended in patients with depressed renal function unless the hypertension is malignant and uncontrolled.
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