Early diagnosis and management of renovascular hypertension

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

“…So far, drug therapy has been the treatment of neonatal hypertension, and nephrectomy has had to be performed in cases of severe renal hypertension with insufficient response to medical therapy [9,10]. Although the condition of the medically managed patients improved, follow-up showed severe atrophy of the affected kidney with loss of function on renal scans [11].…”

Transient renal artery stenosis in infants: myth or reality?

“…Surgical treatment of renal artery stenoses in infants and young children includes nephrectomy (6,7,10) and reconstructive vascular surgery (7,9,10). Over the years, angioplasty has been privileged and with refinement of technique, results have improved dramatically and morbidity has declined appreciably (1 l), although in certain patients nephrectomies are still performed (21).…”

“…Although such cases can be treated surgically, they are not always amenable to surgical intervention and cure (5)(6)(7)(8). We recently had the opportunity to treat two infants with bilateral renal artery stenoses and severe hypertension.…”

Unusual case of recurrent renal artery stenosis: lessons to learn

“…To date, medical therapy remains the initial treatment for neonatal hypertension with nephrectomy reserved in cases of severe renal hypertension refractory to medical therapy. 29,30 Although blood pressure may be controlled in such cases, follow-up imaging often shows severe atrophy of the affected kidney. 31 In infants with RAS, it was historically thought necessary to manage the child medically until they are older and open repair of the vascular abnormalities was deemed feasible.…”