Renovascular Hypertension Program (Pediatric)
Renovascular Hypertension Program (Pediatric)
University of Michigan Health offers expert care through the Pediatric Renovascular Hypertension Program, an international referral center for children and young adults affected by this rare disease. The program offers world-class, patient-centered care with a multidisciplinary team of clinicians and scientists. It is committed to advancing diagnostic tools and novel treatment options through cutting-edge laboratory and clinical research. Team members support and partner with families through care coordination and educational resources.
Our Approach
Children and families from around the world visit our Pediatric Renovascular Hypertension Program for expert help managing and treating renovascular hypertension and complex vascular disease. Our team is renowned for experience with even the most complex forms of midaortic syndrome and renal (kidney) artery disease. The program has maintained a high-volume referral practice over the past five decades and continues to provide the best possible individualized care for each patient.
Our patients receive seamlessly integrated care from a multidisciplinary team that includes leading specialists in vascular surgery, pediatric nephrology, interventional radiology, pediatric urology, anesthesia, pediatric critical care and other sub-specialties. Physicians, nurses and social workers partner with patients, families and collective care teams to personalize treatment and coordinate every step of care and, whenever possible, arranging appointments so that multiple specialists can be seen in a single visit.
We know that receiving care, whether locally or long distance, can be stressful. We strive to provide support for our patients and their families as you navigate your care journey. We also welcome you to visit our Patient & Visitor Guide for helpful resources in planning your visit and support services during your stay.
Our patients receive seamlessly integrated care from a multidisciplinary team that includes leading specialists in the following divisions:
- Vascular surgery: highly trained surgeons who treat diseases of the vascular system.
- Jonathan Eliason, M.D., (Co-Director), Robert Beaulieu, M.D., and Professor Emeritus James Stanley, M.D.
- Pediatric nephrology: specialists that diagnose, treat and manage many disorders affecting the kidney and urinary tract.
- Zubin Modi, M.D., M.S. (Co-Director), David Kershaw, M.D., Kera Luckritz, D.O.
- Interventional radiology: imaging specialists who use x-rays, CT, MRI or other imaging guidance to navigate small instruments, like catheters and needles, through blood vessels and organs.
- David Williams, M.D., Sahira Kazanjian, M.D., Professor Emeritus Kyung Cho M.D.
- Pediatric urology: surgeons who diagnose, treat and manage illness or disease of the genitals or urinary tract (kidneys, ureters, and bladder).
- John Park, M.D.
- Pediatric genetics: specialists that identify genetic diseases, analyzes chromosomes, performs amniocentesis (a procedure used to take out a small sample of the amniotic fluid for testing) for prenatal diagnosis, conduct molecular and DNA diagnostics, and provides genetic counseling.
- Mark Hannibal, M.D., Ph.D., Elizabeth Ames, M.D., Ph.D.
- Pediatric rheumatology: specialists who care for children who have rheumatic (inflammatory) or connective tissue diseases that can affect blood vessels.
- Jessica Turnier, M.D., Meredith Riebschleger, M.D.
- Pediatric anesthesiology:
- Amanpreet (Aman) Kalsi, MBBS
- Pediatric Intensive Care Unit (PICU):
- Stephen Gorga, M.D.
- Social Work: specialists who help patients and their families prepare for their visits and hospitalizations which may include emotional support, assistance with financial need issues, and guidance for sibling and educational support.
- Matthew Butler, MSW
- Research:
- C. Alberto Figueroa, Ph.D., Santhi Ganesh, M.D.
Additionally, our multidisciplinary team collaborates with other sub-specialties to ensure our patients receive high quality and safe care during their treatment at C.S. Mott Children’s Hospital.
1940s – For more than a half-century, Michigan Medicine has been a leader among physicians and scientists studying and treating hypertensive vascular diseases. In 1946, University of Michigan Health established the nation’s second ever dedicated hypertension clinic and, since that time, thousands of adults and children with complex and difficult-to-control hypertension received their care here.
Internist Jerome Conn, M.D. & Surgeon Marion (Bill) DeWeese, MD
1950s – In 1954, U-M internist Jerome Conn, M.D., discovered a curable form of hypertension caused by adrenal gland tumors producing the hormone aldosterone. And three years later, in 1957, the first aortorenal bypass was performed by surgeon Marion (Bill) DeWeese, MD, successfully treating a second curable form of high blood pressure, renovascular hypertension caused by renal artery obstructions.
In 1957, the University of Michigan hosted a seminal meeting of the world’s experts in the field of hypertension. This gathering on “Basic Mechanisms of Arterial Hypertension” included Irving Page, MD, and Eduardo Braun-Menendez, MD who independently had discovered the protein released from kidneys causing blood pressure elevations. At that conference, they agreed to name that substance “angiotensin,” the critical element in renovascular hypertension. Michigan Medicine had become a magnet for those contributing to the understanding and management of this latter form of hypertension, especially that occurring in children.
1970s – The University of Michigan Health’s experience at treating pediatric arterial diseases, including renovascular hypertension, was chronicled in 107 peer-reviewed publications and chapters, beginning in 1973 and most recently in 2021. These reports address renovascular disease genetics, cellular pathology, gross anatomic nature, renal renin production, drug therapies, catheter-based endovascular procedures, and open surgical therapy.
Vascular surgeon James Stanley, MD
1980s – In 1984, U-M faculty published the first monograph in the English language on renovascular hypertension, with scientists and clinicians from throughout the nation contributing to its more than 390 pages. Michigan Medicine was at the forefront of defining the causes and treatment of renovascular hypertension.
1990s – In 1994 the University of Michigan established the nation’s first multispecialty Pediatric Renovascular Hypertension Program. This formalized a large working group of clinicians who cared for children with renovascular diseases. Central to this group’s earlier efforts were vascular surgeon James Stanley, M.D., pediatric nephrologist Robert Kelsch, M.D., pediatric radiologist John Holt, M.D., and interventional angiographer Joseph Bookstein, M.D. The current program involves eight medical disciplines, nursing specialties, and basic sciences.
Vascular surgeon Dawn Coleman, MD
2020s – Children from throughout the world have been treated at Michigan Medicine, including those from hospitals in Europe, the Middle East, Asia, South America, and every major children’s medical center in North America, from Boston and New York to Seattle and San Diego. In 2020, Michigan Medicine initiated a Patient-Centered Outcome Research Program under the leadership of then U-M vascular surgeon Dawn Coleman, M.D., and is co-led by U-M researcher Santhi Ganesh, M.D. The effort involves direct participation of children and families affected by renovascular hypertension, as well as physicians from throughout the globe treating this complex disease. The University of Michigan’s knowledge of renovascular hypertension has its origin in its history of more than a half-century.
The Pediatric Renovascular Hypertension (pRVH) Program team at Mott is committed to clinical transformational research and patient centered outcomes research (PCOR) to improve the diagnosis, care and treatment for children with pediatric renovascular hypertension.
Funded through the Patient Centered Outcomes Research Institute (PCORI), Dawn Coleman, M.D., co-found the pRVH PCOR Collaborative during her time at U-M and U-M research Santhi Ganesh, M.D., is a project co-lead. The pRVH PCOR Collaborative connects patients and their families with the information, resources and support they need to understand the disease and to pursue the best possible treatments and outcomes.
In 2019, U-M hosted the Inaugural Symposium on Pediatric Renovascular Hypertension, which brought together a multidisciplinary group of clinicians and researchers from across the globe, highlighting best practices in patient care and recent discoveries in pRVH. Following the Symposium, the pRVH Patient Centered Outcomes (PCOR) Collaborative was established to expand upon these discussions and to engage patients and their families affected by pRVH as partners.
The Ganesh Lab works on the genetic and mechanistic basis of arterial diseases and hypertension. The arterial changes leading to pRVH are characterized by typically aggressive and adverse vascular remodeling. To study this process, the lab is investigating the genetic and molecular mechanisms of pRVH using state-of-the-art genetic methods and vascular biology approaches.
The Figueroa lab studies the relationship between hemodynamic alterations, vascular remodeling, and hypertension in adult and pediatric populations. The link between disturbed hemodynamics in mid-aortic syndrome and renovascular hypertension is examined through advanced medical imaging, powerful open-source software tools for subject-specific blood flow simulation, machine learning, as well as animal models.
Who We Treat
There are several conditions treated within the Pediatric Renovascular Hypertension Program. Specific diagnoses include:
- Renal artery stenosis
- Midaortic syndrome (abdominal aortic coarctation)
- Arterial aneurysms
- Lower extremity arterial disease
- Intestinal artery (mesenteric) arterial disease
- Takayasu arteritis and other inflammatory arterial disease
- Fibromuscular dysplasia (FMD)
- Dialysis access for end-stage kidney disease patients
- Associated genetic syndromes associated with renovascular hypertension and arterial disease (ie: tuberous sclerosis, neurofibromatosis type 1 or NF1, Williams syndrome, Alagille syndrome)
Appointment Information
For domestic and international referrals, call 734-936-5786 or email [email protected].