| Nephrectomy for hypertension in pediatric patients with a unilateral poorly functioning kidney: A contemporary cohort. | |
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MedLine Citation:
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PMID: 21527219 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: A unilateral poorly or non-functioning kidney is a cause of hypertension in children. We report the outcomes of pediatric patients with unilateral renal parenchymal disease who underwent nephrectomy for hypertension. MATERIALS AND METHODS: Consecutive hypertensive children undergoing nephrectomy with a unilateral poorly or non-functioning kidney were retrospectively reviewed; preoperative and postoperative clinical variables were analyzed. RESULTS: From July 2002 to August 2009, 21 patients (8M:13F) with average age 3.5 years and average follow-up 17.8 months were studied. Eleven patients had multicystic dysplastic kidney, 8 had reflux nephropathy, and 2 had ureteropelvic junction obstruction. Fourteen of 21 (67%) had blood pressure normalization after nephrectomy. Seven of 11 with MCDK were normotensive postoperatively compared to 6/8 patients with reflux nephropathy, and 1/2 patients with UPJ obstruction. Of the 14 patients normotensive postoperatively, 7 were on antihypertensives prior to surgery. Four of 7 patients stopped their anti-hypertensive medications postoperatively, 2 decreased from 3 and 4 medications to 1, and 1 remained on an ACE inhibitor. There were 2 patients with contralateral renal scarring, both of which remained hypertensive postoperatively. CONCLUSIONS: Nephrectomy in hypertensive pediatric patients with a unilateral poorly functioning or non-functioning kidney yielded hypertension resolution in 67% (14/21), permitting cessation or diminution of antihypertensives in many patients. Given the alternative of lifelong antihypertensives with the risk of medication non-compliance and side-effects, nephrectomy is a logical option of care which can be offered to patients and families with informed knowledge of the potential for cure. |
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Authors:
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Bruce J Schlomer; Paul J Smith; Theodore D Barber; Linda A Baker |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-25 |
Journal Detail:
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Title: Journal of pediatric urology Volume: - ISSN: 1873-4898 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101233150 Medline TA: J Pediatr Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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UT Southwestern Department of Urology, 5323 Harry Hines Blvd., Dallas, TX 75390-9110, United States. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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