Malekzadeh M H, Brennan L P, Payne V C, Fine R N
J Pediatr. 1975 Mar;86(3):370-5. doi: 10.1016/s0022-3476(75)80965-6.
Hypertension persisted for longer than 6 mo or developed de novo after the first month following transplantation in seven of 77 pediatric recipients of renal allografts; concomitantly there were an elevation of PRA and renal angiographic abnormalities. In two of the four patients who developed RAS there was evidence of diminished allograft function. Successful correction of the stenotic lesion in these two recipients resulted in a return of the blood pressure, PRA, and biochemical function of the allograft to normal. Unsuccessful attempts at surgical repair led to loss of the allograft in the other two patients with RAS. Intrarenal vascular and/or parenchymal lesions were evident in the other three recipients with hypertension. Although an explanation was not apparent, subclinical rejection was hypothesized. Treatment effected reduction of the hypertension in these three patients and no deterioration of allograft function was observed for periods of 5, 34, and 38 mo, respectively. Renal angiographic studies and determinations of PRA are recommended in any pediatric recipient of an allograft who develops hypertension after the first month following transplantation or has hypertension which persists for longer than 6 mo after transplantation.
在77例小儿肾移植受者中，有7例高血压持续超过6个月，或在移植后第一个月后新发高血压；同时，肾素活性（PRA）升高且肾血管造影异常。在发生肾动脉狭窄（RAS）的4例患者中，有2例出现移植肾功能减退的证据。这2例受者成功纠正狭窄病变后，血压、PRA和移植肾生化功能恢复正常。另外2例RAS患者手术修复失败导致移植肾丢失。其他3例高血压受者可见肾内血管和/或实质病变。尽管原因不明，但推测为亚临床排斥反应。治疗使这3例患者的高血压减轻，分别在5个月、34个月和38个月期间未观察到移植肾功能恶化。对于任何在移植后第一个月后发生高血压或移植后高血压持续超过6个月的小儿移植受者，建议进行肾血管造影研究和PRA测定。
