Pediatric Nephrology

, Volume 30, Issue 8, pp 1289–1295 | Cite as

Impact of revascularization on hypertension in children with Takayasu’s arteritis-induced renal artery stenosis: a 21-year review

  • Taiwo Augustina Ladapo
  • Priya Gajjar
  • Mignon McCulloch
  • Christiaanah Scott
  • Alp Numanoglu
  • Peter Nourse
Original Article

Abstract

Background

Surgery for reno-vascular hypertension (RVH) is complex, and the techniques utilized vary with anatomical presentations of the disease. The long-term outcome of revascularization on RVH in children with Takayasu’s arteritis (TA)-induced renal artery stenosis (RAS) at our centre was reviewed.

Methods

This study was a 21-year retrospective review of pre- and post-intervention RVH in children with angiographically confirmed RAS. The outcome of hypertension was defined as follows: (1) cured (normotensive off anti-hypertensives), (2) improved (normotensive on same or reduced number of medications), or (3) failure (no cure or improvement in number of medications).

Results

The medical histories of 59 children (median age 9.98 years) were reviewed, of whom 20 (44 %) had revascularization procedures. All were hypertensive, with a mean systolic and diastolic blood pressure of 161.5 ± 36 and 106.5 ± 31 mmHg, respectively. RAS was present in 45 (76.3 %) children. Twenty-four revascularization procedures were performed in 20 children (44 %), of whom five had contralateral nephrectomies. Outcome was available for 17 patients at the 3- and 6-months follow-up, with cure, improvement and failure rates at 3 months of 2/17 (11.8 %), 7/17 (41.2 %) and 8/19 (47 %), respectively, and similar rates at 6 months. Associations between outcome and age (p = 0.51), sex (p = 0.32), number of pre-surgery anti-hypertensives (p = 0.18) and stenosis sites (p = 0.22) were not statistically significant.

Conclusions

Revascularization was beneficial to the management of blood pressure control in about half of our RVH patients.

Keywords

Reno-vascular hypertension Takayasu’s arteritis Revascularization Blood pressure Children 

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Copyright information

© IPNA 2015

Authors and Affiliations

  • Taiwo Augustina Ladapo
    • 1
  • Priya Gajjar
    • 2
  • Mignon McCulloch
    • 3
  • Christiaanah Scott
    • 4
  • Alp Numanoglu
    • 5
  • Peter Nourse
    • 2
  1. 1.Pediatric NephrologyDepartment of Pediatrics, College of Medicine, University of Lagos and Lagos University Teaching HospitalLagosNigeria
  2. 2.Pediatric NephrologyDepartment of Pediatric Medicine, Red Cross War Memorial Children’s Hospital, School of Child and Adolescent Health, University of Cape TownCape TownSouth Africa
  3. 3.Pediatric Intensive Care UnitRed Cross War Memorial Children’s Hospital, School of Child and Adolescent Health, University of Cape Town.Cape TownSouth Africa
  4. 4.Pediatric RheumatologyDepartment of Pediatric Medicine, Red Cross War Memorial Children’s Hospital, School of Child and Adolescent Health, University of Cape Town Cape TownSouth Africa
  5. 5.Pediatric SurgeryRed Cross War Memorial Children’s Hospital, School of Child and Adolescent Health, University of Cape Town.Cape TownSouth Africa

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