{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T09:46:23Z","timestamp":1774863983241,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Arterial hypertension in childhood is an increasing health concern, often associated with structural and functional cardiovascular or renal alterations. This study aimed to investigate the prevalence and type of non-stenotic renal artery anatomical variants in children with systemic hypertension and to assess their possible association with cardiac involvement. Methods: A total of 107 children and adolescents with hypertension (mean age 15.4 \u00b1 2.7 years) were evaluated. Hypertension was defined as blood pressure persistently above the 95th percentile for over one year, confirmed by 24 h ambulatory blood pressure monitoring. Patients with known secondary causes were excluded. All underwent renal vascular imaging by CT or MRI and echocardiographic assessment of left ventricular morphology and function. Results: Renal artery anatomical variants were found in 69 of 107 patients (65%), mainly unilateral or bilateral accessory polar arteries. Other anomalies found (left renal vein narrowing or duplication, severe left renal artery stenosis) were excluded from the statistical analysis. Normal renal vasculature was observed in only 32%. Left ventricular hypertrophy was detected in 41%, highlighting a significant prevalence of target-organ involvement. No statistically significant differences were found in terms of hypertension or hypertrophy between patients with renal artery anatomical variants and those without. However, patients with renal anomalies more frequently required dual antihypertensive therapy (p = 0.025). Conclusions: Renal artery anatomical variants, even in the absence of overt stenosis, may contribute to the pathogenesis of pediatric hypertension and complicate its management. Systematic evaluation of renal vasculature should be considered in the diagnostic workup to improve risk stratification and guide management strategies.<\/jats:p>","DOI":"10.3390\/jcm15072610","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:22:36Z","timestamp":1774858956000},"page":"2610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple Renal Arteries as a Potential Contributor to Hypertension in Children and Young Adults"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-5966","authenticated-orcid":false,"given":"Ugo","family":"Giordano","sequence":"first","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-3472","authenticated-orcid":false,"given":"Benedetta","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Cafiero","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello","family":"Chinali","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Arena","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia Cobianchi","family":"Bellisari","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Tranchita","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Gentili","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Chiara","family":"Matteucci","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2611-8061","authenticated-orcid":false,"given":"Aurelio","family":"Secinaro","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00146 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1161\/01.HYP.0000199103.40105.b5","article-title":"for the Strong Heart Study Investigators. 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