HYPERTENSION AND RENAL TUMORS - DIAGNOSIS AND MANAGEMENT

Sporadic cases of hypertension associated with renal tumours in childh ood have been reported, but little is written on the incidence, severi ty, and management of these patients. We report five consecutive infan ts with renal tumours (three Wilms' tumours, one mesoblastic nephroma) and hypertension. The mean age was 12 months (range 2-34 months) and all tumours were stage I. Blood pressure was significantly elevated an d labile in each patient. Preoperative renin levels were raised in all three patients in whom they were measured. Blood pressure was stabili sed preoperatively in all cases. Perioperatively invasive monitoring w as employed and no blood pressure crises were encountered. Tumour remo val was universally successful and the blood pressure returned to norm al after antihypertensives were discontinued. These results suggest a high incidence of hypertension with infantile renal tumours. With preo perative control of blood pressure and perioperative monitoring, nephr ectomy should be a safe procedure.