Child Kidney Dis.  2023 Dec;27(2):117-120. 10.3339/ckd.23.017.

Renal artery stenosis presenting as congenital nephrotic syndrome with hyponatremic hypertensive syndrome in a 2-month-old infant: a case report

• Kim D
• Ahn YH
• Kang HG
• Kim JH
• Lim SH

• KMID: 2549743
• DOI: http://doi.org/10.3339/ckd.23.017

Abstract

Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

Keyword

Case reports; Congenital nephrotic syndrome; Hyponatremic hypertensive syndrome; Renal artery stenosis

Figure

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  Fig. 1. (A) Renal computed tomography (CT) angiography showing asymmetric small size of right kidney with compensatory left renal hypertrophy. (B, C) Renal CT angiography showing the invisible of the right renal artery proximal portion (red circle). (D) Abdomen aortography showing the right renal artery proximal filling defect (red arrow) and mid-portion stenosis (blue arrow).

Reference

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