Impact of revascularization on hypertension in children with Takayasu's arteritis-induced renal artery stenosis: a 21-year review

被引：14

作者：

Ladapo, Taiwo Augustina ^{[1
,2
]}

Gajjar, Priya ^{[3
]}

McCulloch, Mignon ^{[4
]}

Scott, Christiaanah ^{[5
]}

Numanoglu, Alp ^{[6
]}

Nourse, Peter ^{[3
]}

机构：

[1] Univ Lagos, Coll Med, Dept Pediat, Pediat Nephrol, Idi Araba Lagos, Nigeria

[2] Lagos Univ Teaching Hosp, Idi Araba Lagos, Nigeria

[3] Univ Cape Town, Red Cross War Mem Childrens Hosp, Sch Child & Adolescent Hlth, Pediat Nephrol,Dept Pediat Med, ZA-7925 Cape Town, South Africa

[4] Univ Cape Town, Red Cross War Mem Childrens Hosp, Sch Child & Adolescent Hlth, Pediat Intens Care Unit, ZA-7925 Cape Town, South Africa

[5] Univ Cape Town, Red Cross War Mem Childrens Hosp, Sch Child & Adolescent Hlth, Pediat Rheumatol,Dept Pediat Med, ZA-7925 Cape Town, South Africa

[6] Univ Cape Town, Red Cross War Mem Childrens Hosp, Sch Child & Adolescent Hlth, Pediat Surg, ZA-7925 Cape Town, South Africa

来源：

PEDIATRIC NEPHROLOGY | 2015年 / 30卷 / 08期

关键词：

Reno-vascular hypertension; Takayasu's arteritis; Revascularization; Blood pressure; Children; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; RENOVASCULAR HYPERTENSION; PEDIATRIC-PATIENTS; DISEASE; INTERVENTION; BYPASS;

D O I：

10.1007/s00467-015-3049-y

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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.

引用

页码：1289 / 1295

页数：7