RT Book, Section
A1 Janjua, Halima S.
A1 Matar, Raed Bou
A1 Kwon, Charles Y.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114873005
T1 Renovascular Hypertension
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114873005
RD 2023/09/23
AB A  14-year-old  girl  presents  to  your  office  for  a  routine  physical  examination.  She  has  history  of  chronic  headaches  and  complains  about  abdominal  pain  after  eating.  Her  vital  signs  reveal  a  blood  pressure  of  163/100  mm  Hg.  Repeat  manual  blood  pressure  is  152/98  mm  Hg.  You  obtain  laboratory  studies,  which  reveal  a  normal  serum  creatinine,  mild  hypokalemia,  and  elevated  plasma  renin  activity  and  aldosterone  level.  Her  renal  ultrasound  with  Doppler  is  suspicious  for  right  renal  artery  stenosis.  You  start  hypertension  management  with  a  calcium-channel  blocker  and  refer  her  to  a  pediatric  nephrologist,  who  obtains  a  computed  tomography  angiography  (Figure  71-1)  that  reveals  severe  narrowing  of  right  renal  artery.  Her  blood  pressure  remains  sub-optimally  controlled  with  calcium-channel  blockers.  An  angiotensin  II  receptor  blocker  is  added  to  her  hypertension  management.