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Impact of revascularization on hypertension in children with Takayasu's arteritis-induced renal artery stenosis: a 21-year review
- Source :
- Pediatric nephrology (Berlin, Germany). 30(8)
- Publication Year :
- 2014
-
Abstract
- Surgery for reno-vascular hypertension (RVH) is complex, and the techniques utilized vary with anatomical presentations of the disease. The long-term outcome of revascularization on RVH in children with Takayasu's arteritis (TA)-induced renal artery stenosis (RAS) at our centre was reviewed.This study was a 21-year retrospective review of pre- and post-intervention RVH in children with angiographically confirmed RAS. The outcome of hypertension was defined as follows: (1) cured (normotensive off anti-hypertensives), (2) improved (normotensive on same or reduced number of medications), or (3) failure (no cure or improvement in number of medications).The medical histories of 59 children (median age 9.98 years) were reviewed, of whom 20 (44 %) had revascularization procedures. All were hypertensive, with a mean systolic and diastolic blood pressure of 161.5 ± 36 and 106.5 ± 31 mmHg, respectively. RAS was present in 45 (76.3 %) children. Twenty-four revascularization procedures were performed in 20 children (44 %), of whom five had contralateral nephrectomies. Outcome was available for 17 patients at the 3- and 6-months follow-up, with cure, improvement and failure rates at 3 months of 2/17 (11.8 %), 7/17 (41.2 %) and 8/19 (47 %), respectively, and similar rates at 6 months. Associations between outcome and age (p = 0.51), sex (p = 0.32), number of pre-surgery anti-hypertensives (p = 0.18) and stenosis sites (p = 0.22) were not statistically significant.Revascularization was beneficial to the management of blood pressure control in about half of our RVH patients.
- Subjects :
- Nephrology
Male
medicine.medical_specialty
medicine.medical_treatment
Takayasu's arteritis
Renal artery stenosis
Revascularization
Renal Artery Obstruction
Internal medicine
medicine
Humans
Arteritis
Child
Kidney transplantation
Retrospective Studies
business.industry
Retrospective cohort study
medicine.disease
Kidney Transplantation
Takayasu Arteritis
Blood pressure
Hypertension, Renovascular
Treatment Outcome
Pediatrics, Perinatology and Child Health
Cardiology
Female
business
Vascular Surgical Procedures
Subjects
Details
- ISSN :
- 1432198X
- Volume :
- 30
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Accession number :
- edsair.doi.dedup.....2bfff92e22b4bd7d8bc43967de1af7a0