Which lab tests are included in the workup of pediatric renovascular hypertension (RVHT)?

Updated: Dec 01, 2020
  • Author: Rebecca J Schmidt, DO, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Laboratory studies mentioned are often done for completeness and for historical context and are not considered useful as screening tests. Initial tests for both adults and children with hypertension include [26] :

In addition, a fasting lipid panel and fasting glucose level are recommended for the following [26] :

  • Overweight patients whose blood pressure is at the 90th–94 th percentile
  • All patients with blood pressure at the 95th percentile or higher
  • Patients with a family history of hypertension or cardiovascular disease
  • Children with chronic renal disease

Renal function test results frequently yield normal results in children with renovascular disease, even when the lesions are bilateral. Findings on a 24-hour urine study should also be within the reference range in RVHT.

The CBC, serum electrolyte levels, BUN levels, and serum creatinine levels should indicate the presence of renal function impairment or whether a pattern of hyperaldosteronism is present.

A 24-hour urine sample for electrolytes, creatinine, vanillylmandelic acid, catecholamines, 17-hydroxy steroids, and 17-keto steroids should be considered in patients with elevated blood pressure that is not typical of essential hypertension or RVHT.  Normal results should rule out the possibility of a medullary or cortical tumor.

The erythrocyte sedimentation rate (ESR) may be elevated in active arteritis.


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