Follow-up of Pediatric Patients With Renovascular Hypertension in Türki̇ye

Background We aimed to evaluate the treatment and follow-up approaches used in children diagnosed with renovascular hypertension (RVHT). Methods Data from 91 patients diagnosed with RVHT in 20 centers were evaluated retrospectively. Age, blood pressure, and complaints at admission, imaging methods, medications, surgical intervention methods, subsequent progression of blood pressure, and complications were questioned. Results The mean age at admission was 9.7 ± 5.1 years, the systolic blood pressure SDS was 2.24 ± 0.32, and the diastolic blood pressure SDS was 2.03 ± 0.49. Although all patients were diagnosed with at least one angiographic examination, Doppler ultrasonography was normal in 41.7% of the patients. Of the patients, 40.7% had idiopathic renal artery stenosis, 25.3% had fibromuscular dysplasia, 13.2% had Takayasu arteritis, 8.7% had neurofibromatosis, 4.4% had mid-aortic syndrome, and 3.3% had renal artery stenosis in the transplanted kidney. 52.7% of the patients were asymptomatic at the time of diagnosis. 72.3% of the patients were using two or more antihypertensive drugs before surgery. 27.7% had left ventricular hypertrophy. 41.7% of the patients did not undergo any surgical intervention. 30.8% underwent balloon, 5.6% had stents, 1.1% had balloons and stents, 16.4% had angioplasty, 4.4% had patients underwent nephrectomy. The need for antihypertensive drugs decreased or was eliminated in 58.1% of the patients after the procedure. At the last visit, 18.6% were followed without treatment, while 19.7% were using a single antihypertensive drug. Conclusions Since most patients with RVHT are asymptomatic at first presentation, it was concluded that blood pressure measurement is very important. In addition, the number of antihypertensives decreased significantly after an interventional procedure.