Objective: To summarize the clinical characteristics of secondary hypertension caused by renal artery branch stenosis in children. Design and method: We retrospectively collected electronic medical records of 9 children with secondary hypertension due to renal artery branch stenosis who were diagnosed in our center from October 2022 to September 2025. Their clinical features were summarized. These patients were matched in a 1:3 ratio with 27 children diagnosed with primary hypertension, and the differences in clinical and laboratory indicators between the two groups were compared. Results: Among the 9 children with hypertension due to renal artery branch stenosis, 6 were male and 3 were female. The mean age at presentation was (9.3 ± 1.87) years. The mean systolic and diastolic blood pressures on admission were (154.33 ± 26.82) mmHg and (102.22 ± 24.25) mmHg, respectively. The mean BMI was (19.61 ± 3.85) kg/m2. The average time to definitive diagnosis was (6.15 ± 7.53) years. Compared to children with primary hypertension, those with renal artery branch stenosis had significantly lower serum potassium, estimated glomerular filtration rate (eGFR), and glycated hemoglobin (HbA1c) levels, while exhibiting higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, as well as higher supine and upright plasma renin concentrations (p<0.05). Abdominal contrast-enhanced CT scans in all 9 children revealed direct or indirect signs of vascular stenosis, which were subsequently confirmed by selective renal artery angiography demonstrating stenosis in the branch vessels. All 9 children required 2 to 3 antihypertensive agents for blood pressure control. During a mean follow-up period of 1.76 years (range: 0.17-3.67 years), blood pressure normalized allowing for medication discontinuation in 2 cases, while only 1 child remained at stage 2 hypertension. Conclusions: Secondary hypertension caused by renal artery branch stenosis in children is prone to diagnostic delay. Compared to those with primary hypertension, affected children present at a younger age, with lower body weight, significant renin activation, and renal function impairment. Contrast-enhanced CT and selective renal artery angiography are valuable for diagnosis. Antihypertensive management in these cases poses a significant therapeutic challenge.
Lin et al. (Fri,) studied this question.