EPIDEMIOLOGY, CLINICAL FEATURES OFRENAL ARTERY STENOSIS IN CHILDREN

Nguyen Thi Dung, Dang Thi Hai Van, Nguyen Thu Huong

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Abstract

Objectives: To describe the epidemiological and clinical features of renal artery stenosis (RAS) in children at the National Children’s Hospital. Subject and methods: The descriptive study of 28 patients with renal artery stenosis at the National Children’s Hospital from 6/2011 to 6/2021. Results: The median age at diagnosis of RAS is 7 years old. The ratio of male/female: 1/1. RAS of unknown etiology accounted for 50%, Takayasu was the most common cause in 7/28 (25%) patients. At the time of diagnosed: Shortness of breath (42.9%) and headache (25%) were the two main reasons why patients were hospitalized. The proportion of patients with renal artery stenosis with hypertension (hypertensive) accounted for 92,8%, grade 2 hypertension accounted for 82.1%,
32.2% (9/28) patients had hypertensive emergency, there were 3 patients (10.7%) presenting with cardiogenic shock at hospital admission. There are 12 patients with bilateral renal artery stenosis. Two main organs are affected by renal vascular hypertension are the heart and the kidneys: the most common decrease in kidney size accounts for 60.7%, with 16/28 (57.1%) patients having
abnormalities on echocardiography, in which cardiac structural abnormalities are quite common: thick interventricular septum and left ventricular posterior wall (35.7%), dilated left ventricular chamber (39.2%). Conclusion: Renal artery stenosis is often diagnosed in older children. Takayasu is the most common cause of renal artery stenosis. Children with renal artery stenosis most often have severe hypertension, often hospitalized because of symptoms of urgent or emergency hypertension. Two main injured organs in patients with RAS are the heart and the kidney.

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References

1. Weber B.R. and Dieter R.S. (2014). Renal artery stenosis: epidemiology and treatment.
International Journal of Nephrology and Renovascular Disease, 7, 169-181.
2. Srinivasan A., Krishnamurthy G., Fontalvo-Herazo L., et al. (2010). Angioplasty for renal
artery stenosis in pediatric patients: an 11-year retrospective experience. J Vasc Interv Radiol,
21(11), 1672-1680.
3. Lobeck I.N., Alhajjat A.M., Dupree P., et al. (2018). the management of pediatric renovascular
hypertension: a single center experience and revieThe w of the literature. J Pediatr Surg, 53(9),
1825-1831.
4. Chung H., Lee J.H., Park E., et al. (2017). Long-Term Outcomes of Pediatric Renovascular
Hypertension. KBR, 42(3), 617-627.
5. Rountas C., Vlychou M., Vassiou K., et al. (2007). Imaging modalities for renal artery
stenosis in suspected renovascular hypertension: prospective intraindividual comparison of color Doppler US, CT angiography, GD-enhanced MR angiography, and digital substraction
angiography. Ren Fail, 29(3), 295-302.
6. Kari J., Roebuck D., McLaren C., et al. (2014). Angioplasty For Renovascular Hypertension In
78 Children. Archives of disease in childhood.
7. Bayazit A.K., Yalcinkaya F., Cakar N., et al. (2007). Reno-vascular hypertension in childhood:
a nationwide survey. Pediatr Nephrol, 22(9), 1327-1333.
8. Ladapo T.A., Gajjar P., McCulloch M., et al. (2015). Impact of revascularization on
hypertension in children with Takayasu’s arteritisinduced renal artery stenosis: a 21-year review.
Pediatr Nephrol, 30(8), 1289-1295.
9. Rumman R.K., Matsuda-Abedini M., Langlois V., et al. (2018). Management and Outcomes of
Childhood Renal Artery Stenosis and Middle Aortic Syndrome. Am J Hypertens, 31(6), 687-695.
10. Tullus K. (2013). Renovascular hypertension--is it fibromuscular dysplasia or Takayasu arteritis. Pediatr Nephrol, 28(2), 191-196.
11. Vo N.J., Hammelman B.D., Racadio J.M., et al. (2006). Anatomic distribution of renal artery
stenosis in children: implications for imaging. Pediatr Radiol, 36(10), 1032-1036.