Fig. 1: Monitoring of blood pressure and kidney function in patients with TSC.

Current data suggest that the risk of hypertension rises in certain patients with tuberous sclerosis complex (TSC), including those with advanced chronic kidney disease (CKD)61, high angiomyolipoma stage or history of embolization procedures15. When children and adults with TSC are undergoing general anaesthesia, blood pressure should be monitored as part of their pre-anaesthesia assessment. Of note, in infants and young children with TSC, treatment with adrenocorticotropic hormone and corticosteroids increases the risk of hypertension significantly (up to 44%)187 and blood pressure (BP) monitoring should therefore be conducted more frequently than annually for these patients. ABPM, ambulatory blood pressure monitoring; ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; eGFR, estimated glomerular filtration rate; P95, 95th percentile.