ESPN 54th Annual Meeting

ESPN 2022


 
Paediatric patients undergoing renovascular surgery have excellent clinical outcomes and improved quality of life
MOMITHA CHAUDHURY 1 NICOS KESSARIS 1 COLIN FORMAN 1 GEORGE HAMILTON 1 MERYL DAVIS 1 PREMAL PATEL 1 KISHORE MINHAS 1 NADINE DOBBY 1 KJELL TULLUS 1 SAMIRAN RAY 1 JELENA STOJANOVIC 1

1- GREAT ORMOND STREET HOSPITAL FOR CHILDREN NHS FOUNDATION TRUST
 
Introduction:

 

 

Renovascular hypertension is the 3rd most common cause of hypertension in children accounting for 5-10% of childhood hypertension. Hypertension can initially be medically managed however, endovascular interventions or vascular surgery may be necessary in patients who do not achieve good blood pressure(BP) control on medication only. To our knowledge, this is the first study looking into quality of life(QoL) and clinical outcomes in children who underwent renovascular surgery.

Material and methods:

 

Retrospective study on all 22 patients who underwent a renal auto-transplant and/or a renovascular surgery between 2000 and 2021 at Great Ormond Street Hospital for Children NHS Foundation Trust. Data collection was obtained through electronic patient records. The Wilcoxon signed rank test was used. The median and interquartile ranges were reported when data was not normally distributed. Quality of life was assessed using the validated PedsQL™ Transplant Module questionnaires. 

Results:

 

A minority of children (12.3%) with renovascular hypertension required vascular surgery following which, there was a significant improvement in BP control in those who had an auto transplant and an aortic bypass as well as needing to use fewer anti-hypertensive drugs and reduction in number of angioplasties required post-surgery. Patient survival was 100% and kidney function was preserved in all patients.

 

QoL improved with patients needing to take fewer medications and having fewer concerns regarding medicine side effects and body image. Median score was 70 (100 being highest). Patients reported better QoL than their parents. This study identified the importance of holistic care and need for good communication between healthcare professionals and patients in reducing anxiety associated with treatment as well as an enhanced psychological support particularly for adolescents. 

Conclusions:

 

The study reports excellent patient survival, improved BP control, preserved kidney function and improved QoL in patients undergoing renovascular surgery.