Abstract
The management of hypertension associated with UPRD in children constitutes a major therapeutic dilemma, the decision to nephrectomize a patient must be made on the basis of clinical judgment since available diagnostic procedures have not proven useful.
11 patients less than 20 years of age have been studied at the Univ. of Minn, hospital with UPRD. 8 were 15 years or less. Hypertension was found in 8 subjects at routine physical examination; 2 had recurrent urinary tract infections; and 1 had seizures 2 months following a motor accident. All had diastolic pressures greater than 100 mmHg as well as normal renal function. Radiographic studies revealed non-visualization of 1 kidney in 3 patients, unilaterally small kidneys in 7 (5 of which had evidence of scar formation) and a small cortical defect in the upper pole of 1 kidney in 1 patient. Selective renal vein renin determinations were obtained in 6 patients but lateralization to the affected side was noted in only 2 patients.
Surgery appears to have been effective in the majority of patients. 9 are considered cured, 1 is improved on antihypertensive therapy (Aldomet) and 1 has shown no improvement. These results suggest that nephrectomy in cases of hypertension with UPRD offers a better prognosis in young patients than that reported in adults.
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Sinaiko, A., Mirkin, B. & Vernier, R. HYPERTENSION AND UNILATERAL PARENCHYMAL RENAL DISEASE (UPRD). Pediatr Res 8, 461 (1974). https://doi.org/10.1203/00006450-197404000-00725
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DOI: https://doi.org/10.1203/00006450-197404000-00725
