ESPN 50th Annual Meeting

ESPN 2017


 
EVOLUATION OF TREATMENT RESISTANT-HYPERTENSIVE CHILDREN WITH RENAL MAGNETIC RESONANCE ANGIOGRAPHY
UMUT SELDA BAYRAKCI 1 ADEM YASIN KOKSOY 2 ADALET ELÇIN YILDIZ 3 EMEL İSIYEL 2 FATMA SEMSA CAYCI 2 ASLI KANTAR OZSAHIN 2 ALTAN GUNES 3

1- ANKARA YILDIRIM BEYAZIT UNIVERSITY DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- ANKARA CHILD HEALTH HEMATOLOGY ONCOLOGY RESEARCH AND TRAINING HOSPITAL, DEPARTMENT OF PEDIATRIC NEPHROLOGY
3- ANKARA CHILD HEALTH HEMATOLOGY ONCOLOGY RESEARCH AND TRAINING HOSPITAL, DEPARTMENT OF RADIOLOGY
 
Introduction:

 The incidence of accessory renal artery (ARA) varies between 4%-27% in general population. Although most of the cases with renal artery stenosis (RAS) are due to renal vascular involvement of systemic disorders, intrinsic renal vascular abnormalities such as accessory RAS also account an important percentage of renovascular hypertension (RVH) in childhood.  The aim of this study was to investigate renovascular abnormalities with renal magnetic resonance angiography (MRA) in hypertensive children whose blood pressure was difficult to control with medical treatment. 

Material and methods:

Clinical data and MRA findings of 49 treatment resistant hypertensive patients who were followed in our institution between 2015-2017 were analyzed retrospectively.

Results:

Forty nine patients diagnosed with essential hypertension were enrolled in this study. The ambulatory blood pressure measurements (ABPM) of all had revealed increased blood pressure load despite of medical treatment with one antihypertensive drug. Mean systolic blood pressure load was 44,37±7,89 and diastolic blood pressure load was 21,08±3,41 and the mean systolic and diastolic blood pressures in patients with RVA were 139,6±3,2 and 82,7±2,8 respectively, despite of anti-hypertensive medication. The mean age of patients with RVA was 13,6±0,4 years old and 10 of 18 patients were male (55%).  18 of them (36,7%) were found to have renal vascular abnormalities (RVA) consistent with accessory renal artery, 7 were left, 7 were right and 4 were both sided. Plasma renin levels of 12 patients (66%) were within the normal limits. Renal arterial doppler ultrasound was normal in 10 patients (56%).

Conclusions:

 Presence of accessory renal artery is a common finding in hypertensive children and MR angiographic investigation should be kept in mind even in the presence of normal plasma renin levels and renal doppler US.