Research

Salvageability of renal function following renal revascularisation in children with Takayasu’s arteritis-induced renal artery stenosis

Patience Ngozi Obiagwu, Priya Gajjar, Mignon McCulloch, Christian Scott, Alp Numanoglu, Peter Nourse

Abstract


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.

Authors' affiliations

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

Full Text

PDF (96KB)

Keywords

Takayasu's arteritis; Renal artery stenosis; Renal artery revascularisation; Estimated glomerular filtration rate

Cite this article

South African Medical Journal 2016;106(8):813-816. DOI:10.7196/SAMJ.2016.v106i8.10490

Article History

Date submitted: 2015-12-23
Date published: 2016-07-04

Article Views

Abstract views: 1620
Full text views: 536

Comments on this article

*Read our policy for posting comments here