# Aorto-Renal Dysplasia in Childhood: The Overlap of Neurofibromatosis Type 1 and Pediatric Renovascular Hypertension

**Authors:** Eden Singh, Kevin Meyers, Dawn M. Coleman, Santhi K. Ganesh

PMC · DOI: 10.1007/s11906-025-01350-7 · Current Hypertension Reports · 2026-03-16

## TL;DR

This review explores the connection between Neurofibromatosis Type 1 and renovascular hypertension in children, highlighting the need for better diagnostic and treatment guidelines.

## Contribution

The paper emphasizes the need for genotype-targeted guidelines for managing aorto-renal dysplasia in children with NF-1.

## Key findings

- Current understanding of NF-1 and arterial dysplasia relies on single-institution patient reports.
- Management of pediatric renovascular hypertension includes medications and revascularization therapies.
- There is a need for standardized guidelines addressing the genetics and treatment of this condition.

## Abstract

This narrative review aims to summarize what is currently understood about Neurofibromatosis Type 1 (NF-1) and renovascular hypertension (RVH) in children, including clinical presentation and diagnosis, epidemiology, genetics, and management considerations including advances in treatment modalities.

Most of what is currently understood about NF-1 and arterial dysplasia leading to RVH relies on the inclusion of patients with NF-1 in single-institution reports. The management of pediatric RVH often requires multi-modal therapies inclusive of anti-hypertensive medications and revascularization for refractory cases, through catheter-based (i.e., endovascular) and open surgical means. There is a need to develop genotype-targeted guidelines for the diagnosis and management of pediatric aorto-renal dysplasia resulting in RVH in patients with NF-1.

While our understanding of pediatric RVH and NF-1 has evolved over the past decade, critical research questions have emerged that encompass epidemiology, etiology and genetics. These research questions require immediate attention to establish and optimize standardized diagnostic and treatment guidelines.

## Linked entities

- **Diseases:** Neurofibromatosis Type 1 (MONDO:0018975), renovascular hypertension (MONDO:0001105)

## Full-text entities

- **Genes:** CCL2 (C-C motif chemokine ligand 2) [NCBI Gene 6347] {aka GDCF-2, HC11, HSMCR30, MCAF, MCP-1, MCP1}, NF1 (neurofibromin 1) [NCBI Gene 4763] {aka NFNS, VRNF, WSS}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, JAG1 (jagged canonical Notch ligand 1) [NCBI Gene 182] {aka AGS, AGS1, AHD, AWS, CD339, CMT2HH}, ELN (elastin) [NCBI Gene 2006] {aka ADCL1, SVAS, WBS, WS}, NOTCH2 (notch receptor 2) [NCBI Gene 4853] {aka AGS2, HJCYS, hN2}
- **Diseases:** arteriopathy (MESH:D020212), Takayasu arteritis (MESH:D013625), urinary tract anomalies (MESH:D014570), nephrogenic systemic fibrosis (MESH:D054989), congestive heart failure (MESH:D006333), pheochromocytoma (MESH:D010673), SVAS (MESH:D021921), MAS (MESH:C565122), Williams Syndrome (MESH:D018980), hypertrophy (MESH:D006984), Hypertension (MESH:D006973), pulmonic valve stenosis (MESH:D011666), extra-cranial vascular lesion (MESH:D014652), Genetic (MESH:D030342), fracture (MESH:D050723), plexiform neurofibromas (MESH:D018318), HHHS (MESH:C538380), hyponatremia (MESH:D007010), thrombosis (MESH:D013927), seizures (MESH:D012640), cardiovascular abnormalities (MESH:D018376), chronic kidney disease (MESH:D051436), Moyamoya disease (MESH:D009072), Tuberous Sclerosis (MESH:D014402), obstructive uropathy (MESH:C536483), Intimal hyperplasia (MESH:D006965), optic gliomas (MESH:D020339), cafe au lait spots (MESH:D019080), proteinuria (MESH:D011507), gliomas (MESH:D005910), abdominal aortic coarctation (MESH:D001017), Liddle syndrome (MESH:D056929), left ventricular hypertrophy (MESH:D017379), axillary and inguinal ephelides (MESH:D006552), chest pain (MESH:D002637), acute kidney injury (MESH:D058186), aorto-renal occlusive disease (MESH:D001157), restenosis (MESH:D023903), tumor (MESH:D009369), arterial remodeling (MESH:D066253), Arterial Dysplasia (MESH:D012078), abdominal bruits (MESH:D000007), Branch artery disease (MESH:D015356), dysplasia (MESH:D015792), stenoses (MESH:D003251), hyperaldosteronism (MESH:D006929), hypokalemia (MESH:D007008), RVH (MESH:D006978), Inflammatory vasculitis (MESH:D014657), failure to thrive (MESH:D005183), main artery lesions (MESH:D003324), azotemia (MESH:D053099), end-stage renal disease (MESH:D007676), Alagille Syndrome (MESH:D016738), vasculopathies (MESH:D000090122), atherosclerotic arterial fibrodysplasia (MESH:D050197), alkalosis (MESH:D000471), headache (MESH:D006261), fibroplasia (MESH:D012178), shortness of breath (MESH:D004417)
- **Chemicals:** aldosterone (MESH:D000450), creatinine (MESH:D003404), sodium (MESH:D012964), alpha-antagonists (-), Sirolimus (MESH:D020123)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** p.K1444E

## Full text

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Source: https://tomesphere.com/paper/PMC12992459