両側腎動脈狭窄を有する小児腎血管性高血圧症の治療経験

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The authors reported three cases of renovascular hypertension in children in 197411, and one of them (II-year-old boy) had right renovascular hypertension associated with bilateral renal artery stenosis, and the grade of stenosis was more severe in the right renal artery than in the left renal artery. Then, the reconstructive vascular surgery for right renal artery (aortorenal arterial anastomosis) was performed on June 18, 1973 and the blood pressure became normal. Three years after the first operation, hypertension (140-180/40-80 mmHg) appeared again and he was treated with antihypertensive drugs without any effect. He was admitted to our hospital again on July 11 in 1978, when he was 16-year-old, five years after the first operation. The angiotensin analogue test showed positive, PRA increased and the grade of stenosis of the left renal artery has progressed. Hypertension was considered to be due to the left renal artery stenosis, and autotransplantation of the left kidney into his left pelvic cavity was performed and the blood pressure returned normal. The literatures have been reviewed briefly concerning the renovascular hypertension associated with bilateral artery stenosis and the renal autotransplantation for renovascular hypertension in children.
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