Hypertension in a cohort of African children with renal tumours.

Hypertension is a frequent problem in children with renal tumour, yet there are few reports from centres in the third world. A retrospective study of blood pressure in a cohort of 46 patients with renal tumours seen over a 3-year period was carried out. Fifty percent of patients presenting with Wilms' tumour were hypertensive. Serum concentrations of active renin correlated poorly with blood pressure. There was no correlation between serum concentrations of active renin and tumour mass or histology. Specific antihypertensive therapy was offered to 11 patients who had either neurological or cardiac complications of hypertension. All other patients with Wilms' tumour had their blood pressure controlled by neoadjuvant chemotherapy. Patients with mesoblastic nephroma were managed by primary surgery. Patients with asymptomatic hypertension may be monitored as hypertension will resolve with neoadjuvant chemotherapy. Those with compelling symptomatology will require additional hypertensive medication.