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Reno-vascular hypertension in childhood: a nationwide survey

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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.

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Acknowledgement

Dr. Duzova is supported by The Turkish Academy of Sciences (Programme to reward successful young scientists, A.D/TUBA-GEBIP/2006-6).

Author information

Authors and Affiliations

  1. Department of Paediatric Nephrology, School of Medicine, Cukurova University, 01330, Balcali, Adana, Turkey

    Aysun K. Bayazit & Aytul Noyan

  2. Paediatric Nephrology, School of Medicine, Ankara University, Ankara, Turkey

    Fatos Yalcinkaya & Mesiha Ekim

  3. Paediatric Nephrology, SSK Diskapi Hospital, Ankara, Turkey

    Nilgun Cakar & Nazll Kara

  4. Paediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Ali Duzova & Aysin Bakkaloglu

  5. Paediatric Nephrology, School of Medicine, Kocaeli University, Izmit, Turkey

    Zelal Bircan

  6. Paediatric Nephrology, School of Medicine, Cerrahpasa University, Istanbul, Turkey

    Nur Canpolat

  7. Paediatric Nephrology, School of Medicine, Istanbul University, Istanbul, Turkey

    Aydan Sirin

  8. Paediatric Nephrology, Dr. Sami Ulus Children’s Hospital, Ankara, Turkey

    Ayse Oner

  9. Paediatric Nephrology, School of Medicine, Akdeniz University, Antalya, Turkey

    Sema Akman

  10. Paediatric Nephrology, School of Medicine, Ege University, Izmir, Turkey

    Sevgi Mir

  11. Paediatric Nephrology, School of Medicine, Baskent University, Ankara, Turkey

    Esra Baskin

  12. Paediatric Nephrology, School of Medicine, Erciyes University, Kayseri, Turkey

    Hakan M. Poyrazoglu

  13. Paediatric Nephrology, School of Medicine, Celal Bayar University, Manisa, Turkey

    Ipek Akil

  14. Paediatric Nephrology, School of Medicine, Gazi University, Ankara, Turkey

    Sevcan Bakkaloglu

  15. Paediatric Nephrology, School of Medicine, Dokuz Eylul University, Izmir, Turkey

    Alper Soylu

Authors
  1. Aysun K. Bayazit
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  2. Fatos Yalcinkaya
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  3. Nilgun Cakar
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  4. Ali Duzova
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  5. Zelal Bircan
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  6. Aysin Bakkaloglu
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  7. Nur Canpolat
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  8. Nazll Kara
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  9. Aydan Sirin
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  10. Mesiha Ekim
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  11. Ayse Oner
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  12. Sema Akman
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  13. Sevgi Mir
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  14. Esra Baskin
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  15. Hakan M. Poyrazoglu
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  16. Aytul Noyan
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  17. Ipek Akil
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  18. Sevcan Bakkaloglu
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  19. Alper Soylu
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Corresponding author

Correspondence to Aysun K. Bayazit.

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Bayazit, A.K., Yalcinkaya, F., Cakar, N. et al. Reno-vascular hypertension in childhood: a nationwide survey. Pediatr Nephrol 22, 1327–1333 (2007). https://doi.org/10.1007/s00467-007-0520-4

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  • DOI: https://doi.org/10.1007/s00467-007-0520-4

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