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Long-Term Outcomes of Pediatric Renovascular Hypertension.

Long-Term Outcomes of Pediatric Renovascular Hypertension.
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Chung H, Lee JH, Park E, Hyun H, Ahn YH, Jae HJ, Kim GB, Ha IS, Cheong HI, Kang HG,


Chung H, Lee JH, Park E, Hyun H, Ahn YH, Jae HJ, Kim GB, Ha IS, Cheong HI, Kang HG, (click to view)

Chung H, Lee JH, Park E, Hyun H, Ahn YH, Jae HJ, Kim GB, Ha IS, Cheong HI, Kang HG,

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Kidney & blood pressure research 2017 09 2642(3) 617-627 doi 10.1159/000481549
Abstract
BACKGROUND/AIMS
Renovascular hypertension (RVHT) is an important cause of childhood hypertension. This study evaluated the clinical characteristics and outcomes of Korean children with RVHT.

METHODS
Children treated for RVHT between 2000 and 2015 at our center were retrospectively reviewed.

RESULTS
Forty-six children were followed for a median of 6.5 (0.66-27.23) years. Forty-five percutaneous transluminal angioplasties (PTAs) were performed in 32 children. At the last visit, clinical benefit was observed in 53.3% of children. Patients with comorbid cerebrovascular disease (CVD) showed less favorable long-term outcomes after PTA (clinical benefit in 41.7% vs. 61.1% in others) and higher restenosis rates (50% vs. 31.6% in others). Surgical procedures (bypass or nephrectomy) were performed in 8 patients. After surgery, blood pressure was normalized in 2 patients, improved in 3 patients, and unchanged in the remaining patients. Between PTA group (n=21) and medication group (n=14), percentage of atrophic kidneys became higher after follow-up period in medication group than in PTA group (60.0% vs. 26.1%, P=0.037).

CONCLUSION
Aggressive treatment of pediatric RVHT yielded fair outcomes in our cohort. CVD comorbidity was associated with relatively poor PTA outcomes. To confirm our findings, larger cohort studies with a longer follow-up period are warranted.

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