Pediatric Nephrology

, Volume 22, Issue 9, pp 1327–1333 | Cite as

Reno-vascular hypertension in childhood: a nationwide survey

  • Aysun K. Bayazit
  • Fatos Yalcinkaya
  • Nilgun Cakar
  • Ali Duzova
  • Zelal Bircan
  • Aysin Bakkaloglu
  • Nur Canpolat
  • Nazl1 Kara
  • Aydan Sirin
  • Mesiha Ekim
  • Ayse Oner
  • Sema Akman
  • Sevgi Mir
  • Esra Baskin
  • Hakan M. Poyrazoglu
  • Aytul Noyan
  • Ipek Akil
  • Sevcan Bakkaloglu
  • Alper Soylu
Original Article

Abstract

Renovascular disease accounts for 8–10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu’s arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu’s arteritis, should not be underestimated in children with renovascular hypertension.

Keywords

Renovascular hypertension Children Survey Etiology Treatment 

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Copyright information

© IPNA 2007

Authors and Affiliations

  • Aysun K. Bayazit
    • 1
  • Fatos Yalcinkaya
    • 2
  • Nilgun Cakar
    • 3
  • Ali Duzova
    • 4
  • Zelal Bircan
    • 5
  • Aysin Bakkaloglu
    • 4
  • Nur Canpolat
    • 6
  • Nazl1 Kara
    • 3
  • Aydan Sirin
    • 7
  • Mesiha Ekim
    • 2
  • Ayse Oner
    • 8
  • Sema Akman
    • 9
  • Sevgi Mir
    • 10
  • Esra Baskin
    • 11
  • Hakan M. Poyrazoglu
    • 12
  • Aytul Noyan
    • 1
  • Ipek Akil
    • 13
  • Sevcan Bakkaloglu
    • 14
  • Alper Soylu
    • 15
  1. 1.Department of Paediatric Nephrology, School of MedicineCukurova UniversityAdanaTurkey
  2. 2.Paediatric Nephrology, School of MedicineAnkara UniversityAnkaraTurkey
  3. 3.Paediatric NephrologySSK Diskapi HospitalAnkaraTurkey
  4. 4.Paediatric Nephrology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  5. 5.Paediatric Nephrology, School of MedicineKocaeli UniversityIzmitTurkey
  6. 6.Paediatric Nephrology, School of MedicineCerrahpasa UniversityIstanbulTurkey
  7. 7.Paediatric Nephrology, School of MedicineIstanbul UniversityIstanbulTurkey
  8. 8.Paediatric NephrologyDr. Sami Ulus Children’s HospitalAnkaraTurkey
  9. 9.Paediatric Nephrology, School of MedicineAkdeniz UniversityAntalyaTurkey
  10. 10.Paediatric Nephrology, School of MedicineEge UniversityIzmirTurkey
  11. 11.Paediatric Nephrology, School of MedicineBaskent UniversityAnkaraTurkey
  12. 12.Paediatric Nephrology, School of MedicineErciyes UniversityKayseriTurkey
  13. 13.Paediatric Nephrology, School of MedicineCelal Bayar UniversityManisaTurkey
  14. 14.Paediatric Nephrology, School of MedicineGazi UniversityAnkaraTurkey
  15. 15.Paediatric Nephrology, School of MedicineDokuz Eylul UniversityIzmirTurkey

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