Renal hypertension in children

Abstract

Summary The incidence of hypertension in children varied from 1.4 to 2.3 per cent. In contradistinction to adults, essential hypertension is rare in children. Well over 80 per cent of established hypertension is of secondary origin, and in the great majority these cases are secondary to renal disease. The clinical manifestations of renal hypertension in children are variable. They may have no symptoms or may be seen with headache, failure to thrive, visual disturbance, or congestive heart failure. The cure rate following nephrectomy or vascular repair is better in children because of the short duration of their disease. Repair of renal arterial lesions is more difficult in children because of the small size of their vessels. With modern surgical techniques and better case selection, results of renovascular repair are greatly improved. Two cases are reported to illustrate concepts in the management of renovascular and renoparenchymal hypertension. Although the prospects of renal salvage and cure of hypertension are excellent, with segmental renovascular disease unilateral nephrectomy is still applicable for children with renoparenchymal hypertension.