Renal artery revascularisation can restore kidney function with absent radiotracer uptake.

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 [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. [ABSTRACT FROM AUTHOR]