NECESSITY OF BLOOD-PRESSURE CONTROL IN CH ILDREN WITH SUCCESSFUL CORRECTION OF VESICORENAL REFLUX

Renal hypertension represents the most common form of secondary hypert ension in childhood. The main cause is reflux nephropathy. With a mean follow-up of 17 years, 859 children were investigated after successfu l correction of vesicorenal reflux. Renal scars were found in 25.3% pr eoperatively. During the observation period there was an increase in r enal scarring of up to 30.5%. In 10.5% of the patients with renal scar s, arterial hypertension occurred between 12 acid 14 years postoperati vely and was found in 8% of the patients with unilateral reflux nephro pathy, but in 14.5% of those with bilateral reflux nephropathy. Childr en without scars developed no rise in blood pressure. Hypertension is a complication even of successfully corrected vesicorenal reflux. Rena l scarring was found to be an essential precondition for renal hyperte nsion. Therefore blood pressure should be controlled annually on a lon gterm basis throughout childhood and puberty, even after the child has left pediatric care, because there is also a late manifestation of hy pertension, In case of unilateral reflux nephropathy, toss of renal fu nction and significant renal vein renin ratio, blood pressure can be n ormalized by nephrectomy.