Renal vascular disease and renovascular hypertension in children.

Renal vascular disease is the second most common cause of secondary pediatric hypertension, usually occurring as intimal or atypical medial-perimedial stenoses. Developmental lesions account for 40 per cent of these stenoses. Assessments of renin activity and arteriography are useful in identifying functionally important lesions. Urography in this age group has little diagnostic utility. Renal revascularization offers a 95 per cent beneficial outcome to properly selected patients.