Pediatric urological causes of hypertension

Abstract

Purpose: We reviewed the association of hypertension with several common pediatric urological conditions.

Materials and methods: We comprehensively reviewed the published literature linking hypertension with urinary tract infection, renal scarring, vesicoureteral reflux, multicystic dysplastic kidney, ureteropelvic junction obstruction and posterior urethral valves.

Results: Hypertension is a recognized sequela of several common pediatric urological conditions. It is thought to be a direct consequence of renal damage or scarring often resulting from vesicoureteral reflux and/or febrile urinary tract infection. Multicystic dysplastic kidney has rarely been shown to cause hypertension when examined in large series rather than as isolated case reports. Ureteropelvic junction obstruction and posterior urethral valves have been linked to hypertension, although to our knowledge no series to date has specifically examined this relationship and smaller retrospective reviews seldom describe associated hypertension.

Conclusions: Several pediatric urological conditions are known to cause hypertension. However, methodological flaws in the literature, including a lack of standardized blood pressure followup, highly variable patient populations and poor control of concomitant urological abnormalities, greatly limit the ability to establish a causative link between any 1 specific condition and hypertension. Early diagnosis, the prevention of infection, close clinical followup and early intervention remain the primary means of preventing pediatric urological causes of hypertension.