Salvageability of renal function following renal revascularisation in children with Takayasu’s arteritis-induced renal artery stenosis
Background. Renal artery revascularisation procedures are usually carried out on children with renal artery stenosis from varied causes, including Takayasu’s arteritis. Reports on the outcome of such procedures in children usually refer to the improvement in blood pressure, with only minimal mention of effects on renal function.
Objective. Salvageability of renal function in children who underwent renal revascularisation for Takayasu’s arteritis-induced renal artery stenosis (TARAS) was the focus of this study.
Methods. We undertook a retrospective analysis of children aged ≤16 years with angiographically confirmed TARAS who underwent renal artery revascularisation procedures between 1990 and 2010. Outcomes of renal function were studied over a period of 2 years and were defined as: (i) improvement: >20% increase in estimated glomerular filtration rate (e-GFR) from presurgery value; (ii) stabilisation: e-GFR within 20% of presurgery value; and (iii) failure: >20% deterioration in e-GFR from presurgery value. The GFR was estimated using the Schwartz formula.
Results. Twenty children (9 males and 11 females, age range 2 - 14 years) had 27 renal artery revascularisation procedures. Thirteen of the patients (65.0%) had bilateral renal artery stenosis. The baseline mean e-GFR was 88.6 (standard deviation (SD) 25.4) mL/min/1.73 m2 and the mean duration of follow-up was 28.80 (SD 25.62) months. All the patients had stable or improved renal function until the 2-year follow-up, when the proportion decreased to 92.3% (12/13), as failure was recorded in one child. Bilateral revascularisation was found to be significantly associated with improvement in renal function in the early postoperative period (p=0.04).Conclusion. Renal artery revascularisation procedures are successful in salvaging renal function in children with TARAS.
Patience Ngozi Obiagwu, Paediatric Nephrology Unit, Aminu Kano Teaching Hospital, Kano, Nigeria; Paediatric Nephrology Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Priya Gajjar, Paediatric Nephrology Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Mignon McCulloch, Paediatric Intensive Care Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Christian Scott, Paediatric Rheumatology Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Alp Numanoglu, Paediatric Surgery Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Peter Nourse, Paediatric Nephrology Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
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Date published: 2016-07-04
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