Renal auto transplantation for renovascular hypertension associated with bifurcated renal artery stenosis in a pediatric patient

Abstract

Background: Renovascular hypertension (RVH) accounts for 10–15% of secondary hypertension in children. RVH is often due to intrinsic renal arterial disease causing stenosis which may also sometimes involve the aorta and other arteries. RVH is treatable in children by surgical and medical interventions. The surgical options for treating RVH depends on the location, severity and vascular abnormality caused by the underlying disease. Case presentation: A 3-year-old Caucasian girl presented with refractory hypertension. Computed tomography showed right renal artery stenosis. Endovascular therapy was considered, but was not feasible due to early renal artery bifurcation and extension of the stenosis into the bifurcation. To preserve kidney function and to treat the hypertension, the patient underwent renal auto transplant. She recovered without complications with preservation of renal function and resolution of her hypertension. Conclusion: We present a case of RVH associated with bifurcated renal artery stenosis successfully treated by renal auto transplantation. Even though endovascular therapy applications are growing in pediatric patients, open surgical treatment for complex RVH is still an important treatment option. Keywords: Renal artery stenosis, Renovascular hypertension, Renal auto transplantation