Renovascular Hypertension
What Is Renovascular Hypertension?
Renovascular hypertension is high blood pressure caused by a problem with the blood vessels that supply blood to the kidneys. This condition is called renal artery stenosis (RAS). It can affect one side (unilateral) or both sides (bilateral). RAS is uncommon, but it can lead to severe high blood pressure and heart issues if it’s not diagnosed and treated properly.
What Causes RAS in Children?
In children, RAS is often caused by a condition called fibromuscular dysplasia. This is a disease that affects the kidney arteries, making them narrow and sometimes form bulges (aneurysms).
Other possible causes include:
- Neurofibromatosis type I (NF1)
- Williams syndrome
- Alagille syndrome
- Vasculitis (inflammation of blood vessels)
- Connective tissue disorders
- Tuberous sclerosis syndrome
What Are the Signs and Symptoms of Renal Artery Stenosis in Children?
Most children with high blood pressure will not have symptoms or feel any different. But when it's caused by renal artery stenosis (RAS) — a narrowing of the blood vessels going to the kidneys — it often shows up earlier and more severely. Children may have symptoms like:
- Headaches
- Feeling tired
- Nosebleeds
Even if there aren’t obvious symptoms, RAS can lead to serious problems like:
- Thickening of the heart
- Heart and kidney dysfunction
- Trouble with learning or even seizures
Because of these risks, doctors usually order imaging tests to look at the kidney blood vessels in any child with early or severe high blood pressure.
How is RAS Diagnosed and Treated?
Treating children with renovascular hypertension secondary to RAS is complex and requires a team of specialists, including kidney doctors (pediatric nephrologists), interventional radiologists, surgeons and dietitians. The care plan usually includes:
- Starting blood pressure medicine
- Finding out what’s causing the RAS (sometimes with help from genetic experts)
- Checking for damage to organs like the heart, brain, or kidneys
- Detailed imaging of the kidney arteries using computed tomography (CT) imaging, magnetic resonance imaging (MRI), or by a conventional angiogram with interventional radiology
- After all tests are done, the care team will talk with you about the best management plan, including procedures with interventional radiology and/or with surgical team.
Why Choose Us?
The Division of Nephrology and Hypertension at Nationwide Children’s provides comprehensive treatment to children and adolescents with kidney and urinary tract problems. Among the conditions addressed are kidney failure, developmental abnormalities of the kidneys, urinary tract infections, kidney stones, nephrotic syndrome, high blood pressure, metabolic bone disease, lupus and inflammatory diseases of the kidneys such as glomerulonephritis. Nationwide Children's is ranked by U.S. News & World Report for Nephrology.
