Duplex sonography of renal arteries as a diagnostic tool in hypertensive children

Rosendahl, W; Grunert, Dustin; Schöning, M.

doi:10.1007/bf02190666

Cited by 11 publications

(7 citation statements)

References 9 publications

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“…Renal artery stenosis can be diagnosed noninvasively as in our patient by Doppler sonography [5,6]. Fibromuscular dysplasia is the most frequent cause of isolated renal artery stenosis.…”

Section: Discussionmentioning

confidence: 97%

Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Hofbeck

Rupprecht

et al. 1998

European Journal of Pediatrics

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“…Renal artery stenosis can be diagnosed noninvasively as in our patient by Doppler sonography [5,6]. Fibromuscular dysplasia is the most frequent cause of isolated renal artery stenosis.…”

Section: Discussionmentioning

confidence: 97%

Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Hofbeck

Rupprecht

et al. 1998

European Journal of Pediatrics

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“…Renal arteriography is not easy to perform, but remains the gold standard for diagnosing renovascular hypertension. While Doppler ultrasonography and magnetic resonance imaging have their advocates [6,7], assessing their diagnostic utility requires the performance of all three tests -renal arteriogram, Doppler study, and magnetic resonance angiogram -in an unselected group of children with hypertension to properly evaluate each test. Although such a research and failure to control hypertension effectively with one drug are useful criteria to guide the application of renal arteriography in children with hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…For these reasons, it is not universally performed for the evaluation of pediatric hypertension. Although newer imaging modalities, such as digital subtraction angiography, magnetic resonance imaging, and Doppler ultrasonography, may be useful in the diagnosis of renovascular hypertension in adult and pediatric patients [5][6][7], these less-invasive and lessexpensive tests have not yet been rigorously evaluated in children. Thus, there are no standard recommendations regarding the use of renal arteriography in children with hypertension [8,9].…”

Section: Introductionmentioning

confidence: 99%

Yield of renal arteriography in the evaluation of pediatric hypertension

et al. 2000

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The prevalence of renovascular disease is estimated to be 3%-5% in pediatric patients with hypertension. The utility of non-invasive imaging tests has not been evaluated in children, and renal arteriography remains the diagnostic test of choice. However, there are no established guidelines for the application of this test and information is not available about the likelihood of detecting an abnormality if an arteriogram is performed in children with hypertension. Therefore, we reviewed the yield of renal arteriography in pediatric patients if the test was performed based on the following two criteria: (1) severe hypertension exceeding the 99th percentile for age and sex or (2) failure to control high blood pressure with one antihypertensive drug. During the period 1983-1998, 28 children (mean age 11.7 years) who satisfied one of the above criteria underwent renal arteriography to investigate hypertension. None of the patients were renal transplant recipients. The average duration of hypertension was 11 months and the peak blood pressure was 168/107 mmHg. The renal arteriogram was abnormal in 12 patients (43%). Unilateral renal artery stenosis was the most-common abnormality. When the patients were divided into two groups - those with an abnormal or normal test result - they did not differ in age, sex, or racial distribution. The peak systolic blood pressure was higher in children with an abnormal renal arteriogram (P<0.05). Among those undergoing the arteriogram on the basis of the first criterion, i.e., severe hypertension, 11 of 23 (48%) studies were abnormal. Five children had an arteriogram based on the second criterion--failure to control the blood pressure with one medication--and in 1 patient (20%) the test was abnormal. We conclude that the prevalence of renovascular disease in a population of hypertensive children subjected to renal arteriography is around 40%. Two clinical criteria--namely severe hypertension or failure to control hypertension effectively with one drug--are useful to guide the application of renal arteriography in children with hypertension.

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“…Grunert and coworkers 21 published perfusion measurements of renal arteries in healthy children, and Rosendahl and colleagues 22 investigated the renal perfusion in hypertensive children with diverse renal diseases.…”

Section: Discussionmentioning

confidence: 99%

Color Doppler sonographic determination of renal blood flow in healthy children.

Scholbach

1999

Journal of Ultrasound in Medicine

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he determination of renal blood flow is of great interest in many clinical settings that alter renal function, such as acute or chronic renal failure, inflammation, scarring, swelling, trauma, operations, and other conditions. Renal perfusion is the necessary prerequisite of renal function. Depression of renal perfusion will lead to loss of function when the functional reserve of the kidney has become exhausted. Until now pediatricians have been dependent on relatively insensitive indicators of renal function, such as creatinine or urea concentrations, or has had to carry out time-consuming or expensive procedures like tests of clearances or nuclear medical investigations. A bedside method for evaluating renal perfusion is therefore desirable.Color Doppler sonography offers the possibility of measuring renal perfusion parameters even in small or chronically ill children. Only semiquantitative techniques have been established. The most commonly used are RI and PI. These indices reflect relationships of blood flow velocities at various points in one cardiac cycle but do not give any information about the volume of blood passing through the kidneys. They were the first parameters to describe the spectral analysis of the renal Doppler sonographic The volumetric measurement of the real renal perfusion is of interest in many clinical situations. It promises better understanding of renal function and development in healthy children and in children with acute or chronic renal failure, inflammation of any type, scarring, swelling, trauma, operations, and other conditions. Until now only scintigraphic techniques allowed measurement of the renal plasma flow in clinical practice. With color Doppler sonography all relevant data to calculate the volume of blood that passes through the kidney in a certain time can be measured. The aim of this paper is to investigate the utility of color Doppler sonography in describing renal perfusion in 63 healthy children in four separate age groups. It can be shown that the perfusion volume related to the body surface area is constant throughout childhood. Its mean value is 383 ml/min ⋅ m 2 .The results of the new technique of color Doppler sonographic volumetric determination of renal blood flow are then compared in 21 pediatric patients with the results of scintigraphic determination of the renal perfusion by 123 I-hippurate clearance. This way a significant correlation of both methods can be demonstrated.

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Duplex sonography of renal arteries as a diagnostic tool in hypertensive children

Cited by 11 publications

References 9 publications

Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Yield of renal arteriography in the evaluation of pediatric hypertension

Color Doppler sonographic determination of renal blood flow in healthy children.

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