Hyun Chung1, Jae Hwan Lee2, Eujin Park1, Hyesun Hyun1, Yo Han Ahn3, Hwan Jun Jae4,5, Gi Beom Kim1,5, Il Soo Ha1,5, Hae Il Cheong1,5, Hee Gyung Kang1,5. 1. Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea. 2. Division of Intervention, Department of Radiology, National Cancer Center Hospital, Goyang, Republic of Korea. 3. Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea. 4. Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. 5. Seoul National University, College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND/AIMS: Renovascular hypertension (RVHT) is an important cause of childhood hypertension. This study evaluated the clinical characteristics and outcomes of Korean children with RVHT. METHODS: Children treated for RVHT between 2000 and 2015 at our center were retrospectively reviewed. RESULTS: Forty-six children were followed for a median of 6.5 (0.66-27.23) years. Forty-five percutaneous transluminal angioplasties (PTAs) were performed in 32 children. At the last visit, clinical benefit was observed in 53.3% of children. Patients with comorbid cerebrovascular disease (CVD) showed less favorable long-term outcomes after PTA (clinical benefit in 41.7% vs. 61.1% in others) and higher restenosis rates (50% vs. 31.6% in others). Surgical procedures (bypass or nephrectomy) were performed in 8 patients. After surgery, blood pressure was normalized in 2 patients, improved in 3 patients, and unchanged in the remaining patients. Between PTA group (n=21) and medication group (n=14), percentage of atrophic kidneys became higher after follow-up period in medication group than in PTA group (60.0% vs. 26.1%, P=0.037). CONCLUSION: Aggressive treatment of pediatric RVHT yielded fair outcomes in our cohort. CVD comorbidity was associated with relatively poor PTA outcomes. To confirm our findings, larger cohort studies with a longer follow-up period are warranted.
BACKGROUND/AIMS: Renovascular hypertension (RVHT) is an important cause of childhood hypertension. This study evaluated the clinical characteristics and outcomes of Korean children with RVHT. METHODS:Children treated for RVHT between 2000 and 2015 at our center were retrospectively reviewed. RESULTS: Forty-six children were followed for a median of 6.5 (0.66-27.23) years. Forty-five percutaneous transluminal angioplasties (PTAs) were performed in 32 children. At the last visit, clinical benefit was observed in 53.3% of children. Patients with comorbid cerebrovascular disease (CVD) showed less favorable long-term outcomes after PTA (clinical benefit in 41.7% vs. 61.1% in others) and higher restenosis rates (50% vs. 31.6% in others). Surgical procedures (bypass or nephrectomy) were performed in 8 patients. After surgery, blood pressure was normalized in 2 patients, improved in 3 patients, and unchanged in the remaining patients. Between PTA group (n=21) and medication group (n=14), percentage of atrophic kidneys became higher after follow-up period in medication group than in PTA group (60.0% vs. 26.1%, P=0.037). CONCLUSION: Aggressive treatment of pediatric RVHT yielded fair outcomes in our cohort. CVD comorbidity was associated with relatively poor PTA outcomes. To confirm our findings, larger cohort studies with a longer follow-up period are warranted.
Authors: Dawn M Coleman; Jonathan L Eliason; Robert Beaulieu; Tatum Jackson; Monita Karmakar; David B Kershaw; Zubin J Modi; Santhi K Ganesh; Minhaj S Khaja; David Williams; James C Stanley Journal: J Vasc Surg Date: 2020-04-08 Impact factor: 4.268
Authors: Juliana Lacerda de Oliveira Campos; Letícia Bitencourt; Ana Luisa Pedrosa; Diego Ferreira Silva; Filipe Ji Jen Lin; Lucas Teixeira de Oliveira Dias; Ana Cristina Simões E Silva Journal: Pediatr Nephrol Date: 2021-04-13 Impact factor: 3.714