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The role of unilateral nephrectomy in the treatment of nephrogenic hypertension in children
Author(s) -
Johal Navroop S.,
Kraklau David,
Cuckow Peter M.
Publication year - 2005
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.05266.x
Subject(s) - medicine , nephrectomy , renovascular hypertension , blood pressure , renal artery , kidney disease , secondary hypertension , fibromuscular dysplasia , surgery , kidney , disease , urology
OBJECTIVES To define the efficacy of unilateral nephrectomy in a large series of patients presenting with renal disease and hypertension, as the latter may be a prominent finding in children with nephrourological disease (renal parenchymal disease, renovascular disease, obstruction, renal dysplasia and cancer). PATIENTS AND METHODS We retrospectively reviewed the hospital and outpatient records of 118 children who presented for evaluation with hypertension, and who had a nephrectomy between 1968 and 2003. Patients included in the study were those who had a unilateral nephrectomy for benign renal hypertension with a normal contralateral kidney; in all, 21 had complete records and follow‐up were evaluated. The hypertension was associated with primary renal disease, obstruction and renovascular disease. Blood pressure and medication requirements were compared before and after surgery, the blood pressure values also being compared with published nomograms. RESULTS Patients were diagnosed with hypertension at a median age of 5 years and had a nephrectomy at a median of 11 months after the diagnosis. The median follow‐up after surgery was 39 months. Most patients responded well and became normotensive, or there was a reduction in the need for medication. The median time to normalization was 2, 10 and 11 days in patients with primary renal disease, obstruction and renovascular disease, respectively. CONCLUSION Nephrectomy is successful in normalizing blood pressure in children with benign renal hypertension and with a normal contralateral kidney.