Bachmann H, Behrendt H
Urologe A. 1985 Mar;24(2):102-5.
Chronic hypertension in children with obstructive uropathy perhaps is an infrequent, but not unimportant condition. In patients with bilateral obstruction often accompanied by urinary tract infection, hypertension may develop in spite of restoration of urinary flow. Hypertension in these patients is caused by parenchymal damage of one or both kidneys resulting as a late sequela of obstruction even after normalisation of urinary flow. This report deals with three cases of this type of obstructive uropathy and severe hypertension. Hypertension developed up to 6 years after normalisation of urinary flow. In the two patients, in who serum renin examinations were performed, high renin levels were determined peripherally (6.2-7.9 ng/ml/h) and in both kidney veins (8.5-34.7 ng/ml/h). Early diagnosis and treatment of hypertension may have important implications for the outcome of these patients. In all patients glomerular filtration rate was diminished (31.6-67.8 ml/min X 1.73 m2), in two of them further deterioration during the observation period of 3-4 years could be avoided.
梗阻性尿路病患儿的慢性高血压可能并不常见，但并非不重要。在双侧梗阻且常伴有尿路感染的患者中，即使恢复了尿流，高血压仍可能发生。这些患者的高血压是由一侧或双侧肾脏的实质损害引起的，这是梗阻的晚期后遗症，即使尿流恢复正常也是如此。本报告涉及三例此类梗阻性尿路病和严重高血压病例。高血压在尿流恢复正常后长达6年才出现。在进行了血清肾素检查的两名患者中，外周血肾素水平较高（6.2 - 7.9 ng/ml/h），双侧肾静脉肾素水平也较高（8.5 - 34.7 ng/ml/h）。高血压的早期诊断和治疗可能对这些患者的预后具有重要意义。所有患者的肾小球滤过率均降低（31.6 - 67.8 ml/min×1.73 m²），其中两名患者在3 - 4年的观察期内避免了病情进一步恶化。
