Surgical treatment of vasorenal hypertension in children and adolescents

Problems of the surgical treatment of vasorenal hypertension in children are elucidated as well as types of reconstruction of the renal arteries, indications and contra-indications for surgery. Results of 34 operations fulfilled for fibromuscular lesions of the renal arteries in 32 patients and causes of reoperations and resection of the organs are analyzed.     

Various aspects of surgical treatment of vasorenal hypertension]

The results of examination and treatment by surgery of 103 patients with vasorenal hypertension are analysed. Retromboses and restenoses of the reconstructed renal arteries and grafts and uncorrected hyperaldosteronism were the most frequent causes of the poor results. Adequate reconstruction of the renal arteries leads to correction of hyperaldosteronism in patients with normal or high activity of plasma renin. Low-renin secondary hyperaldosteronism in patients with vasorenal hypertension is an indication for simultaneous correction.     

Surgical treatment of vasorenal hypertension in non-specific aorto-arteritis]

An injury to the renal arteries was found in 119 patients with non-specific aorto-arteritis and high arterial hypertension by means of angiography. 66 patients were operated upon (75 operations). The reconstruction of one renal artery was carried out upon 31 patients, 30 patients underwent the reconstruction of both renal arteries. 6 patients were subjected to the primary nephrectomy, and 6 others to the secondary one. The blood flow along the aorta and visceral arteries was restored in 31 cases in one-stage operation together with the reconstruction of the renal arteries. In recent years the postoperative mortality has constituted 4.3%. Excellent and good results have been obtained in 83.6% of cases.     

Mathematical modeling of the degree of nephroarteriolosclerosis in vasorenal hypertension

Comparison of the findings of clinical, instrumental, and laboratory examination of patients with vasorenal hypertension with the results of morphological analysis of renal bioptic material showed that multivariate regression analysis of the parameters of examination of the patients provides for authentic calculation of the quantitative index of nephroarteriolosclerosis--the vascular index of the afferent arterioles of the renal glomeruli. The calculated values of the vascular index for both kidneys are criteria for choosing the method of operative intervention in vasorenal hypertension.