Neonatal hypertension: diagnosis and management

Flynn, Joseph T.

doi:10.1007/s004670050771

Cited by 161 publications

(128 citation statements)

References 92 publications

(103 reference statements)

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“…1 SAH secondary to bronchopulmonary dysplasia usually appears later in life, around the third or fourth month of life; these children belong to a risk group for SAH, especially when the use of corticosteroids and xanthines has to be instituted. 1,9,10 Skalina et al…”

Section: Discussionmentioning

confidence: 99%

“…These newborns show a greater chance to develop arterial hypertension, which may be secondary to a pre-existent morbid condition or to adverse effects associated with diagnostic and therapeutic interventions. 1 The definition of SAH is not totally established in the neonatal period yet. Blood pressure (BP) values are lower in neonates than in older children and increase proportionally with gestational age and birth weight, increasing approximately 1 mm Hg a day in the first 3-8 days of life, and 1 mm Hg a week between the fifth and sixth weeks of life.…”

Section: Introductionmentioning

confidence: 99%

“…1 The more prevalent aetiologies of SAH in the neonate are renal arterial thrombosis, aorta coarctation, congenital renal malformations and bronchopulmonary dysplasia. 4 In this article, we describe our experience with SAH associated with nephro-urological malformations during the neonatal period in a tertiary care referral nursery during a period of 4 years.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

Lanzarini¹,

Furusawa²,

Sadeck³

et al. 2006

J Hum Hypertens

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An increase in the survival of neonates with antenatal diagnosis of malformations was achieved by the recent technical advances in neonatal intensive care units. The aim of this article is to describe the experience with neonatal arterial hypertension, in newborns with nephro-urological malformations, in a tertiary care referral Nursery, in a period of 4 years. Newborn medical records from the Nursery Annex to the Maternity of Hospital das Clinicas, School of Medicine, University of Sao Paulo, with the diagnosis of nephro-urological malformations and systemic arterial hypertension (SAH) at hospital discharge, in a period from January 1999 to January 2003, were retrospectively analysed. Among 10.278 live newborns in the studied period, 15 (0.15%) newborns were compatible with our inclusion criteria. Of these 15 newborns, 12 (80%) were male and three were premature (20%). In relation to aetiology, 13 (87%) showed urological malformations, 1 (6%) chronic renal insufficiency secondary to kidney dysplasia and one (6%) autosomal recessive polycystic kidney disease. SAH control was achieved with monotherapy in eight patients (53%), five patients (33%) needed an association of two drugs (calcium-channel blocker and angiotensin converting enzyme (ACE) inhibitor), one child used three types of antihypertensive drugs (calcium-channel blocker, ACE inhibitor and hydrochlorothiazide) for pressoric control and one child's blood pressure (BP) was controlled exclusively by peritoneal dialysis. The incidence of nephro-urological malformations in our service during the studied period was 0.89%. SAH incidence among these newborns was 19%. Our data reinforce previous studies pointing to the necessity to consider children with nephro-urological malformations as a risk group for SAH, who should have the BP evaluated since the neonatal period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

Lanzarini¹,

Furusawa²,

Sadeck³

et al. 2006

J Hum Hypertens

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“…Most cases of hypertension in infants are caused by renovascular, renal parenchymal, or cystic disease [35]. Renovascular disorders may account for approximately one-half of the cases of neonatal hypertension [36].…”

Section: The Specific Case Of Renovascular Hypertension Of Infantsmentioning

confidence: 99%

Captopril-enhanced renal scintigraphy in the diagnosis of pediatric hypertension

et al. 2010

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Hypertension in childhood is no longer a rare condition mainly secondary to renal, or renovascular diseases, as a growing proportion of children are obese and hypertensive, with the phenotype of metabolic syndrome. Thus, we need to reconsider our practice in the examination of the hypertensive child and redefine the place of non-invasive methods for screening of renovascular hypertension, and specifically, to evaluate the value of captopril-enhanced renal scintigraphy at the two ends of the palette: the obese child with hypertension and the severely hypertensive prepubertal child. Renal artery stenosis in children is mainly due to fibromuscular dysplasia and stenoses associated with syndromes involving single or multiple smaller branch vessels. This explains the low specificity and sensitivity of the color-Doppler ultrasound method and captopril renal scintigraphy. Even the more sophisticated computed tomography (CT) and magnetic resonance imaging (MRI) angiographic techniques are, at present, not sensitive enough to exclude stenoses of the small branches definitely. Thus, children in whom there is a strong suggestion of renovascular hypertension should undergo angiography with a view to endovascular treatment, as non-invasive imaging has no significant benefit and might lead to a delay in treatment. In the cases when the probability of renovascular disease is moderate a basic assessment of renal function and structure is sufficient. In the neonate, catheter-associated thromboembolic disease is among the most common causes hypertension. It should be controlled medically until the patient is old enough to undergo angiography and angioplasty successfully. Thus, in this age group, there is a place for functional imaging with renal sonography and angiotensin-converting enzyme inhibitor (ACEI) renography to detect hemodynamically significant renovascular disease, with the limitations mentioned above. However, the rapid technical evolution of non-invasive methods requires periodic re-consideration of the actual standpoints.

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“…The broad spectrum of causes includes potential life-threatening renal arterial stenosis [1,2]. In children it is mainly due to fibromuscular dysplasia and stenosis associated with syndromes involving single or multiple small branch vessels [3,4].…”

Section: Introductionmentioning

confidence: 99%

Severe renal vascular hypertension caused by upper left branch renal artery stenosis complicated with multiple thrombosis and cardiac hypertrophy

et al. 2014

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AbstractA severe hypertension was found in a 9 month old boy with signs and symptoms of severe arterial hypertension. An upper left branch renal artery stenosis complicated with multiple thrombosis and cardiac hypertrophy was diagnosed. Surgical heminephrectomy of the upper pole of the left kidney was successful in blood pressure normalization with significant improve of cardiac function and thrombosis recanalization.

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Neonatal hypertension: diagnosis and management

Cited by 161 publications

References 92 publications

Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

Neonatal arterial hypertension in nephro-urological malformations in a tertiary care hospital

Captopril-enhanced renal scintigraphy in the diagnosis of pediatric hypertension

Severe renal vascular hypertension caused by upper left branch renal artery stenosis complicated with multiple thrombosis and cardiac hypertrophy

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