We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Diagnosis and Management of Renovascular Hypertension in Children

James D. Lawson, MD; Robert Boerth, MD; John H. Foster, MD; Richard H. Dean, MD
Arch Surg. 1977;112(11):1307-1316. doi:10.1001/archsurg.1977.01370110041004.
Text Size: A A A
Published online


• Over the past 15 years, we have evaluated 107 hypertensive children. A renal origin of hypertension was identified in 30 patients, and 25 have undergone operative management. In the group undergoing operation, ages ranged from 2 months to 19 years. Twelve patients were male and 13 were female. Anatomic lesions included fibromuscular dysplasia (16 patients), renal artery trauma (two patients), renal artery involvement by aortic coarctation (two patients), chronic pyelonephritis (two patients), renal hypoplasia (two patients) and contralateral renal artery stenosis after irradiation for Wilms' tumor (one patient). The rapid sequence intravenous pyelogram was abnormal in only 52%. Renal revascularization was attempted in 17 patients. Nine patients had nephrectomy and three children had segmental resections. Bilateral procedures have been performed in four children. Follow-up observations from 4 months to 13 years (mean, four years) are available. Seventeen children (68%) were cured, six (24%) improved, and two (8%) had no change in blood pressure. Both children not improved and four of the six children showing only improvement had recurrent or residual renal artery disease limiting the result. Bilateral disease has occurred in seven of the 16 children (44%) with fibromuscular dysplasia. These results support an aggressive approach to the diagnosis and management of hypertension in childhood. The bilateral nature of fibromuscular dysplasia in these children stresses the long-term superiority of revascularization over nephrectomy in their management.

(Arch Surg 112:1307-1316, 1977)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.