NEPHRECTOMY IN JUVENILE HYPERTENSION ASSOCIATED WITH RENAL DISEASE

Fifteen children who had hypertension apparently associated with renal ischemia underwent nephrectomy. Of 11 who presumably had unilateral renal disease, 9 were observed for at least 1 year with 8 maintaining normal blood pressure and 1 still being hypertensive. Four children were believed to have bilateral renal disease but with greater impairment of function of one kidney than the other. Removal of the more severely affected kidney in these children did not result in reduction of the blood pressure. Three of the four were dead in from 2 months to 6 years after nephrectomy and in the fourth hypertension persisted after 2½ years. The presence of hypertension in a child demands thorough investigation as to the etiology since the hypertension may be of the secondary type and therefore often curable.