Renovascular hypertension.

Renovascular disease constitutes approximately 10% of cases of secondary hypertension in childhood. It is associated with neurofibromatosis and a number of other syndromes. Fibromuscular dysplasia is the commonest histopathological finding. Bilateral and intrarenal disease is common and is associated with extrarenal arterial disease in a significant proportion of cases. Utilizing currently available investigative procedures, the nature of the disease can be defined and decisions made regarding appropriate treatment. However, although there is the potential for surgical cure, a substantial number of children still require medical therapy probably due to the high incidence of bilateral and small intrarenal arterial involvement that is not amenable to surgical or angioplasty treatment.