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Autotransplantation for renovascular hypertension in children with solitary functioning kidney

Journal of Human Hypertension volume 27, pages 340–342 (2013)Cite this article

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Previous case studies have demonstrated that renal autotransplantation proved to be a valuable technique in the treatment of renovascular hypertension (RVH) caused by vascular anomalies. 1 There is, however, limited pediatric data on autotransplantation of a solitary functioning kidney with renal artery stenosis. 2

We report on two children with refractory RVH, who underwent autotransplantation of solitary functioning kidney. We describe the long-term postoperative course of their hypertension assessed by means of repeated ambulatory BP monitoring (ABPM),3 glomerular filtration rate (GFR) by measuring the plasma clearance of iohexol4 and hypertensive end-organ damage determined, according to validated routine clinical investigations.5

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References

  1. Terpstra JL, van Schilfgaarde R, Zwartendijk J . Extracorporeal renal surgery. Neth J Surg 1981; 33 (4): 165–172.

    CAS  Google Scholar 

  2. Kaufman JJ, Alferez C, Navarrete RV . Autotransplantation of a slitary functioning kidney for renovascular hypertension. J Urol 1969; 102 (2): 146–150.

    Article  CAS  Google Scholar 

  3. Krmar RT, Berg UB . Blood pressure control in hypertensive pediatric renal transplants: role of repeated ABPM following transplantation. Am J Hypertens 2008; 21 (10): 1093–1099.

    Article  Google Scholar 

  4. Berg UB, Back R, Celsi G, Halling SE, Homberg I, Krmar RT et al. Comparison of plasma clearance of iohexol and urinary clearance of inulin for measurement of GFR in children. Am J Kidney Dis 2011; 57 (1): 55–61.

    Article  CAS  Google Scholar 

  5. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009; 27 (9): 1719–1742.

    Article  CAS  Google Scholar 

  6. Kuwertz-Broeking E, Brinkmann OA, Von Lengerke HJ, Sciuk J, Fruend S, Bulla M et al. Unilateral multicystic dysplastic kidney: experience in children. BJU Int 2004; 93 (3): 388–392.

    Article  CAS  Google Scholar 

  7. Ruttenberg HD . Pre- and postoperative exercise testing of the child with coarctation of the aorta. Pediatr Cardiol 1999; 20 (1): 33–37 discussion 38.

    Article  CAS  Google Scholar 

  8. Stanley JC, Criado E, Upchurch GR, Brophy PD, Cho KJ, Rectenwald JE et al. Pediatric renovascular hypertension: 132 primary and 30 secondary operations in 97 children. J Vasc Surg 2006; 44 (6): 1219–1228 discussion 1228-1229.

    Article  Google Scholar 

  9. Brenner BM, Mackenzie HS . Nephron mass as a risk factor for progression of renal disease. Kidney Int Suppl 1997; 63: S124–S127.

    CAS  Google Scholar 

  10. Herthelius M, Celsi G, Edstrom Halling S, Krmar RT, Sandberg J, Tyden G et al. Renal transplantation in infants and small children. Pediatr Nephrol 2011; 27 (1): 145–150.

    Article  Google Scholar 

  11. Collste P, Haglund K, Lundgren G, Magnusson G, Ostman J . Reversible renal failure during treatment with captopril. Br Med J 1979; 2 (6190): 612–613.

    Article  CAS  PubMed  Google Scholar 

  12. Hall JE, Guyton AC, Jackson TE, Coleman TG, Lohmeier TE, Trippodo NC . Control of glomerular filtration rate by renin-angiotensin system. Am J Physiol 1977; 233 (5): F366–F372.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department for Clinical Science, Division of Paediatrics, Karolinska Institutet, Intervention and Technology, Karolinska University Hospital, Huddinge, Sweden

    R T Krmar

  2. Department of Transplantation Surgery, Karolinska University Hospital, Huddinge, Sweden

    J Sandberg & G Tydén

  3. Department of Paediatrics, Central Hospital, Västerås, Sweden

    L Ghahramani & W Sikorska

  4. Department of Radiology, Karolinska University Hospital, Huddinge, Sweden

    N Dahmane & A Svensson

Authors
  1. R T Krmar
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  2. J Sandberg
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  3. L Ghahramani
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  4. W Sikorska
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  5. N Dahmane
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  6. A Svensson
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  7. G Tydén
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Corresponding author

Correspondence to R T Krmar.

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The authors declare no conflict of interest.

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Author contributions

RTK was responsible for the preoperative and postoperative clinical follow-up of Case 1, referred Case 2 for surgical consideration of RVH and wrote the paper. JS was the leading surgeon in both cases and drew Figures 1B and D. LG and WS were responsible for the preoperative and postoperative clinical follow-up of Case 2. ND did the radiological imaging and interpretation. AS did the three-dimensional volume imaging rendering reconstruction. GT assisted the surgeries. All authors approved the final version of the paper.

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Krmar, R., Sandberg, J., Ghahramani, L. et al. Autotransplantation for renovascular hypertension in children with solitary functioning kidney. J Hum Hypertens 27, 340–342 (2013). https://doi.org/10.1038/jhh.2012.40

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