Pediatric nephrology (Berlin, Germany) · 2012
Renal artery revascularisation can restore kidney function with absent radiotracer uptake.
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Tse Yincent, Marks Stephen D, Brennan Eileen, Hamilton George, McLaren Clare A, Roebuck Derek J, Tullus Kjell
Аннотация
BACKGROUND: Children with renovascular hypertension often present with severe hypertension. Some children have severe obstruction of their renal arteries resulting in <10% relative function on [(99m)Tc]dimercaptosuccinic acid (DMSA) scan. Conventional treatment of these children has been nephrectomy of the poorly functioning kidney to normalise their blood pressure (BP).
CASE-DIAGNOSIS/TREATMENT: We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery.
CONCLUSION: These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
CASE-DIAGNOSIS/TREATMENT: We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery.
CONCLUSION: These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
Предметные рубрики MeSH
Angioplasty, BalloonBlood Vessel Prosthesis ImplantationChildChild, PreschoolGlomerular Filtration RateHumansHypertension, RenovascularInfantKidneyMalePerfusion ImagingPredictive Value of TestsRadiopharmaceuticalsRecovery of FunctionRenal ArteryRenal Artery ObstructionRenal CirculationTechnetium Tc 99m Dimercaptosuccinic AcidTreatment OutcomeUltrasonography, Doppler, Color