Pediatric Renal Vascular Disease

What is Renal Vascular Disease?

The renal arteries carry blood from the aorta, the main artery supplying oxygen-rich blood from the heart, to the kidneys. Renal vascular disease happens when the renal arteries become narrowed or blocked, reducing blood flow to the kidneys.

Reduced blood flow can prevent the kidneys from functioning normally to remove waste from the body. If left untreated, renal vascular disease can cause high blood pressure (hypertension) and chronic kidney disease.

What Causes Renal Vascular Disease?

The most common causes of renal vascular disease in children are:

• Congenital or developmental defects that happen during fetal (before birth) growth and cause the renal arteries to narrow
• Fibromuscular dysplasia (FMD), abnormal tissue growth inside artery walls that blocks blood flow

Symptoms of Renal Vascular Disease

Many children show no symptoms of renal vascular disease. High blood pressure (hypertension) is often the first noticeable sign, and other signs and symptoms include:

• Headaches
• Vomiting
• Dizziness
• Seizures
• Irritability and poor feeding, in infants

How is Renal Vascular Disease Diagnosed?

Renal vascular disease can cause dangerous conditions such as high blood pressure (hypertension) and chronic kidney disease. With treatment, renal vascular disease is almost always curable and rarely recurs.

If your child has sudden, uncontrollable high blood pressure, your pediatrician may recommend any of the following tests to determine whether the cause is renal vascular disease:

• Repeat blood pressure measurements done on your child’s arms and legs to verify high blood pressure
• Blood and urine tests for substances that indicate kidney dysfunction
• Diagnostic imaging, including CT and MRI scans and vascular ultrasound to check for problems in renal arteries (a noninvasive procedure)
• Arteriography, a type of catheterization (see below), to view the inside of the renal arteries

Treatments for Renal Vascular Disease

At Children’s National, we treat renal vascular disease using interventional cardiac catheterization, specifically angioplasty. This procedure opens the artery and restores blood flow to the kidney. The pediatrician inserts a tiny, flexible tube into your child’s artery, with either of the following tools:

• A balloon that inflates, presses the blockage into the artery walls, and is deflated and removed
• A stent (a tiny wire mesh tube) that is inserted into the artery at the blockage to hold the artery open

Learn more about our cardiology program and cardiac catheterization at Children’s National.