Yincent Tse1, Stephen D Marks2, Eileen Brennan2, George Hamilton3, Clare A McLaren4, Derek J Roebuck4, Kjell Tullus2. 1. Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. yincent@doctors.net.uk. 2. Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. 3. Department of Vascular Surgery, Royal Free Hospital, London, UK. 4. Department of Radiology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
Abstract
BACKGROUND: Children with renovascular hypertension often present with severe hypertension. Some children have severe obstruction of their renal arteries resulting in <10% relative function on [(99m)Tc]dimercaptosuccinic acid (DMSA) scan. Conventional treatment of these children has been nephrectomy of the poorly functioning kidney to normalise their blood pressure (BP). CASE-DIAGNOSIS/TREATMENT: We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery. CONCLUSION: These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
BACKGROUND:Children with renovascular hypertension often present with severe hypertension. Some children have severe obstruction of their renal arteries resulting in <10% relative function on [(99m)Tc]dimercaptosuccinic acid (DMSA) scan. Conventional treatment of these children has been nephrectomy of the poorly functioning kidney to normalise their blood pressure (BP). CASE-DIAGNOSIS/TREATMENT: We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery. CONCLUSION: These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
Authors: James C Stanley; Enrique Criado; Gilbert R Upchurch; Patrick D Brophy; Kyung J Cho; John E Rectenwald; David B Kershaw; David M Williams; Ramon Berguer; Peter K Henke; Thomas W Wakefield Journal: J Vasc Surg Date: 2006-10-20 Impact factor: 4.268
Authors: Beom Hee Lee; So Hee Lee; Hyun Jin Choi; Hee Gyung Kang; So Won Oh; Dong Soo Lee; Il Soo Ha; Yong Choi; Hae Il Cheong Journal: Pediatr Nephrol Date: 2009-07-05 Impact factor: 3.714
Authors: Marike B Stadermann; Giovanni Montini; George Hamilton; Derek J Roebuck; Clare A McLaren; Michael J Dillon; Stephen D Marks; Kjell Tullus Journal: Nephrol Dial Transplant Date: 2009-10-21 Impact factor: 5.992
Authors: Matthew A Corriere; Jeffrey D Pearce; Matthew S Edwards; Jeanette M Stafford; Kimberley J Hansen Journal: J Vasc Surg Date: 2008-09 Impact factor: 4.268