Involvement of the central nervous system in renal hypertension

European Journal of Pediatrics
K SchärerW Rascher

Abstract

Involvement of the central nervous system (CNS) is a major complication of renal hypertension and is usually due to hypertensive encephalopathy. During a 17-year period we observed 25 children with renal hypertension associated with CNS manifestations in the absence of (group A) and 33 in the presence of advanced renal failure (group B). Convulsions were the most important symptom (65% in both groups combined). Other manifestations were reduced consciousness (69%), visual disturbances (28%), hemiplegia (14%), and cranial nerve palsy (10%). In 56% of children in group A, hypertension was recognised only after appearance of CNS symptoms. Three patients in group A and 19 in group B died. Intracranial haemorrhage associated with hemiplegia was found in 3 cases. From 1970-1977 to 1978-1986 the number of patients and the mortality in group B declined dramatically, probably as a result of improved antihypertensive and renal replacement therapy. In contrast, in group A the number of patients and of CNS symptoms remained similar. The study underlines the importance of frequent blood pressure monitoring in presence of acute or chronic renal disease.

References

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Citations

Feb 1, 1996·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·U ReissK Schärer
Jun 1, 1995·Seminars in Ultrasound, CT, and MR·J CinnamonJ H Dorey
Sep 8, 2005·Veterinary Pathology·C A BrownS A Brown
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Dec 1, 2007·Journal of the Royal Society of Medicine·C M EverettM Lobo
May 20, 2003·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S SchillingJ Sperner

Related Concepts

Teens
Diastolic Blood Pressure
CNS Disorder
Renal Hypertension
Kidney Failure, Chronic
Retrospective Studies

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