Braren V, West J C, Boerth R C, Harmon C M
Department of Urology, Vanderbilt University School of Medicine, Nashville, Tennessee.
Urology. 1988 Sep;32(3):228-34. doi: 10.1016/0090-4295(88)90390-1.
During a ten-year period, 35 children presenting with vesicoureteral reflux, ureteropelvic junction obstruction, or a "small kidney" were found to be hypertensive. Of these, 15 subsequently underwent surgical procedures for relief of hypertension. Seven were "cured," six were "improved," and two were "unchanged." The severity of hypertension could not be correlated with the degree of reflux nor with the degree of obstructive uropathy. However, all children with reflux in our study who were hypertensive had some degree of calicectasis noted preoperatively on intravenous pyelogram. Also it was noted that hypertension may occur several years after successful anti-reflux surgery. Children with vesicoureteral reflux, ureteropelvic junction obstruction, or a small kidney need to have blood pressure determinations at regular intervals, even if all previous readings had been in the normotensive range and whether or not they were followed up medically or post surgically. We suggest that blood pressure determinations be made every three months for the first year after diagnosis of reflux or ureteropelvic junction obstruction, and at least once a year thereafter.
在十年期间，发现35名患有膀胱输尿管反流、肾盂输尿管连接处梗阻或“小肾”的儿童患有高血压。其中，15名儿童随后接受了手术以缓解高血压。7名“治愈”，6名“改善”，2名“无变化”。高血压的严重程度与反流程度或梗阻性尿路病程度无关。然而，在我们的研究中，所有高血压的反流儿童术前静脉肾盂造影均显示有一定程度的肾盏扩张。还注意到高血压可能在成功的抗反流手术后数年出现。患有膀胱输尿管反流、肾盂输尿管连接处梗阻或小肾的儿童需要定期测量血压，即使之前所有读数都在正常血压范围内，无论他们是否接受药物治疗或手术治疗。我们建议在诊断反流或肾盂输尿管连接处梗阻后的第一年每三个月测量一次血压，此后至少每年测量一次。
