Intrarenal Arterial Stenosis

Doody, Patrick T.; Wombolt, Duane G.; Tynes, William V.; Goldberg, Marvin

doi:10.1177/000992288202100105

Cited by 1 publication

(1 citation statement)

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“…SVS for renin has a limited role in pediatric renovascular disease. It can usually be assumed that renal arterial stenosis demonstrated by angiography in a hypertensive child is functionally significant [18]. On the other hand, an elevated unilateral or segmental renin is of doubtful clinical value if technically adequate selective renal arteriograms are negative.…”

Section: Discussionmentioning

confidence: 99%

Pediatric hypertension: an approach to imaging

et al. 1986

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Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound in identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension.

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Section: Discussionmentioning

confidence: 99%