Pediatric renovascular hypertension (pRVH) is defined by high blood pressure resulting from renal artery and abdominal aortic occlusive disease (ie: narrowings, stenosis). It is the third most common form of hypertension in children, behind intrinsic kidney disease and coarctation of the thoracic aorta. The exact incidence of pRVH as a cause of secondary hypertension in the pediatric population is unknown, but is likely to account for 8% to 10% of those exhibiting marked blood pressure elevations and while the overall incidence is low, this disease accounts for a much larger proportion of high blood pressure in children than in the adult population.
What are the symptoms of pediatric renovascular hypertension?
Patients typically do not show symptoms though headache, visual changes and poor growth are sometimes associated. Without treatment, serious complications may occur, including heart enlargement and thickening, heart failure, kidney dysfunction and neurologic complications such as stroke.
It’s unclear why children develop this condition. But some syndromes are known to be associated with it, including:
- Neurofibromatosis type I (NF1): a genetic condition characterized by changes in skin coloring and tumors along nerves in the skin, brain and other parts of the body
- Alagille syndrome: a genetic disorder that can affect the liver, heart, and other parts of the body
- Moyamoya disease: a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain
- Williams syndrome: a developmental disorder characterized by heart and blood vessel problems alongside mild to moderate intellectual disability or learning problems and distinctive facial features.
Conditions treated by the Pediatric Renovascular Hypertension Program
There are several conditions treated within the Pediatric Renovascular Hypertension Program. Specific diagnoses include:
- Renal artery stenosis
- Midaortic syndrome (abdominal aortic coarctation)
- Arterial aneurysms
- Lower extremity arterial disease
- Intestinal artery (mesenteric) arterial disease
- Takayasu arteritis and other inflammatory arterial disease
- Fibromuscular dysplasia (FMD)
- Dialysis access for end-stage kidney disease patients
- Associated genetic syndromes associated with renovascular hypertension and arterial disease (ie: tuberous sclerosis, neurofibromatosis type 1 or NF1, Williams syndrome, Alagille syndrome)