Timing of procedural interventions in childhood renovascular hypertension.
Pediatr Nephrol
; 36(10): 3089-3096, 2021 10.
Article
en En
| MEDLINE
| ID: mdl-34143295
ABSTRACT
BACKGROUND:
Renovascular hypertension (RVHTN) is a rare, often complex condition due to multiple etiologies including congenital stenoses, vasculitides, and fibromuscular dysplasia. Among children with RVHTN who require multiple and escalating medications to control blood pressure, the optimal timing of a procedural intervention involves a balance of numerous factors. CASE-DIAGNOSIS/TREATMENT In this presentation of a 1-month-old girl with RVHTN, the treating medical team had to consider multiple factors in the initial management and timing of interventions to treat her underlying cause of RVHTN, including concerns for kidney health, degree of hypertension, age and size of the patient, and potential methods of procedural intervention. Initially, she was treated conservatively until concern for poor renal growth arose and a durable surgical intervention was thought feasible and safe.CONCLUSION:
The evidence regarding the timing of non-medical interventions in pediatric RVHTN is limited. Considerations should include patient age, size, disease severity, comorbid conditions, and degree of medical management required to maintain safe blood pressures that allow for growth and reverse cardiac damage. The optimal interventions have not been evaluated by controlled trials and should be decided on a case-by-case basis with consideration of center expertise and family preferences.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Obstrucción de la Arteria Renal
/
Displasia Fibromuscular
/
Hipertensión
/
Hipertensión Renovascular
Tipo de estudio:
Etiology_studies
Límite:
Child
/
Female
/
Humans
/
Infant
Idioma:
En
Revista:
Pediatr Nephrol
Asunto de la revista:
NEFROLOGIA
/
PEDIATRIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos