Abstract Ref Number = APCP1093
CASE REPORT RENAL ARTERY STENTING IN A 10 YEAR OLD GIRL WITH HYPERTENSION
Irena Rosdiana,Heru muryawan,Omega Mellyana,Rochmanadji Widajat,Antonius Gunawan,Agustina Wulandari
Departements of Pediatrics Faculty of Medicine Diponegoro University Dr Kariadi Hospital Departement of Radiology, Faculty of Medicine, Diponegor UniversityDr Kariadi Hospital Semarang Departement of Pediatrics, Faculty of Medicine, Sebelas Maret UniversityDr Moewardi Hospital, Solo
Background : Renal artery stenosis (RAS) is one of the etiologies of secondary hypertension and accounts for approximately 1–3 % of all causes of hypertension. We report a rare case a 10-year-old girl with RAS complicated with stage two hypertension
Case Presentation Summary : A 10-year-old girl presented with hypertension stage two and history of recurrent crisis hypertension, chronic kidney disease stage three and profound renal artery stenosis, was transferred to our institution and performed renal artery stenting . She has had hypertension for 3 years and taken antihypertensive drug for 5 months. On admission the blood pressure (BP) was 159/88, the antihypertensive drug are furosemide 20 mg, nifedipin 10 mg, spironolakton 12.5 mg, propanolol 2.5 mg, she also takes digoxin 0.25 mg, sildenafil 12.5 mg and dorner 10 mcg. Laboratory examination showed serum creatinine (Cr) 0.8 mg/dl, ureum 43 mg/dl, serum sodium 138 mmol/L, serum potassium 3.6 mmol/L, serum chlorida 95 mmol/L. CT Angiography showed stenosis of the left renal artery from abdominal aortic branch to arcuate artery. Echocardiography showed left ventricle hypertrophy with decreased contractility to 46 %. A left renal artery stenting was performed succesfully on 23ed Mei 2018. Two days after intervention, she still has stage two hypertension, she was discharged and prescribed clopidogrel, aspilet and diuretic
Learning Points/Discussion : The goal management of secondary hypertension in renal artery stenosis are BP control in order to preserve renal function, and avoid complication. Renal artery stenting should be considered as the first-line modality for RAS in children. Monitoring BP, serum creatinin should be done continuosly every one month.
Keywords: renal artery stenosis hypertension stent