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Case Reports
. 2019 Feb 21;20(1):64.
doi: 10.1186/s12882-019-1246-9.

Unilateral renal artery stenosis presented with hyponatremic-hypertensive syndrome - case report and literature review

Jhao-Jhuang Ding  1   2 , Shih-Hua Lin  3 , Jin-Yao Lai  4 , Tai-Wei Wu  5 , Jing-Long Huang  6 , Hung-Tao Chung  7 , Min-Hua Tseng  8
Affiliations
Case Reports

Unilateral renal artery stenosis presented with hyponatremic-hypertensive syndrome - case report and literature review

Jhao-Jhuang Ding et al. BMC Nephrol. .

Abstract

Background: Renal artery stenosis is one of the secondary causes of pediatric hypertension. Cases with critical unilateral renal artery stenosis manifesting with the hyponatremic hypertensive syndrome are rare and a comprehensive description of this disorder in the pediatric population is lacking in the literature.

Case presentation: We describe a 4-year-old boy who presented with severe hypertension, profound hyponatremia, hypokalemia, nephrotic range proteinuria, and polyuria. Distinctly, the diagnosis of hyponatremic hypertensive syndrome secondary to unilateral renal artery stenosis was confirmed in light of laboratory and radiographic findings of severe natriuresis, elevated renin, and unilateral small kidney. Two weeks following nephrectomy, there was resolution of hyponatremia, hypokalemia, nephrotic range proteinuria and hypertension.

Conclusions: Findings of hyponatremia, hypokalemia, hypertension, polyuria, and unilateral renal hypoplasia can be attributed to a unifying pathology of unilateral renal artery stenosis.

Keywords: Hyponatremic-hypertensive syndrome; Renal artery stenosis.

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Not applicable.

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Written informed consent was obtained from the parents/guardians of the children.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Computed tomographic angiography with maximum intensity projection. The axial view demonstrated the small caliber of the left renal artery (black arrow) with the compensatory change of the contralateral renal artery (white arrow)
Fig. 2
Fig. 2
Possible mechanism of hyponatremic-hypertensive syndrome
See this image and copyright information in PMC

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