Abstract
Sporadic cases of hypertension associated with renal tumours in childhood have been reported, but little is written on the incidence, severity, and management of these patients. We report five consecutive infants with renal tumours (three Wilms' tumours, one mesoblastic nephroma) and hypertension. The mean age was 12 months (range 2–34 months) and all tumours were stage I. Blood pressure was significantly elevated and labile in each patient. Preoperative renin levels were raised in all three patients in whom they were measured. Blood pressure was stabilised preoperatively in all cases. Perioperatively, invasive monitoring was employed and no blood pressure crises were encountered. Tumour removal was universally successful and the blood pressure returned to normal after antihypertensives were discontinued. These results suggest a high incidence of hypertension with infantile renal tumours. With preoperative control of blood pressure and perioperative monitoring, nephrectomy should be a safe procedure.
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References
American Heart Association (1967) Recommendations for human blood pressure determination by sphygmomanometers. Circulation 36: 980–988
Bauer JH, Durham JD, Miles J, Hakami N, Groshong T (1979) Congenital mesoblastic nephroma presenting with primary reninism. J Pediatr 95: 268–272
Colan SD, Fuji A, Borow KM, MacPherson D, Sanders SP (1983) Noninvasive determination of systolic, diastolic and end-systolic blood pressure in neonates, infants and young children: comparison with central aortic pressure measurements. Am J Cardiol 52: 867–870
Cook HT, Taylor GM, Malone PS, Risdon RA (1988) Renin in mesoblastic nephroma: an immunohistochemical study, Hum Pathol 19: 1347–1351
De Swiet M, Fayers P, Shinebourne EA (1980) Systolic blood pressure in a population of infants in the first year of life: the Brompton study, Pediatrics 65: 1028–1036
Haber E, Koerner T, Page LB, Kliman B, Purnode A (1969) Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. J Clin Endocrinol Metab 29: 1349–1355
Khan AB, Carachi R, Leckie BJ, Lindop GBM (1991) Hypertension associated with increased renin concentrations in nephroblastoma. Arch Dis Child 66: 525–526
Malone PS, Duffy PG, Ransley RA, Risden RA, Cook T, Taylor M (1989) Congenital mesoblastic nephroma, renin production, and hypertension, J Pediatr Surg 24: 599–600
National Heart, Lung and Blood Institute, Bethesda, Maryland (1987) Report of the Second Task Force on Blood Pressure Control in Children, 1987. Pediatrics 79: 1–25
Robertson PW, Klidjian A, Harding LK, Walters G (1967) Hypertension due to a renin-secreting tumour. Am J Med 43: 963–976
Silas JH, Barker AT, Ramsay LE (1980) Clinical Evaluation of Dinamap 845 automated blood pressure recorder. Br Heart J 43: 202–205
Spahr J, Demers LM, Schochat SJ (1981) Renin-producing Wilms' tumor. J Pediatr Surg 16: 32–34
Whyte RK, Elseed AM, Fraser CB, Shinebourne EA (1975) Assessment of Doppler ultrasound to measure systolic blood pressures in infants and young children. Arch Dis Child 50: 542–544
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Correspondence to: P. S. Malone
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Simpson, H.K., Malone, P.S., Griffiths, D.M. et al. Hypertension and renal tumours: diagnosis and management. Pediatr Surg Int 8, 502–504 (1993). https://doi.org/10.1007/BF00180355
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DOI: https://doi.org/10.1007/BF00180355