Hyponatraemic hypertensive syndrome in two extremely low birthweight infants

:  Two cases of hyponatraemic hypertensive syndrome occurring in extremely low birthweight infants are presented. Both infants experienced unilateral renal ischaemia resulting in hyponatraemia and hypertension. A proposed pathophysiological mechanism, namely unilateral renal ischaemia leading to a p...

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Bibliographic Details
Published in:Journal of paediatrics and child health 2003-05, Vol.39 (4), p.312-314
Main Author: Bourchier, D
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Humans
Hypertension
Hypertension - complications
Hypertension - etiology
hyponatraemia
Hyponatremia - complications
Hyponatremia - etiology
Infant, Newborn
Infant, Very Low Birth Weight
Intensive care medicine
Ischemia - complications
Kidney - blood supply
Male
Medical sciences
neonates
Newborn babies
Retrospective Studies
Risk factors
Sodium deficiency
Syndrome
Very low birth weight babies
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Summary::  Two cases of hyponatraemic hypertensive syndrome occurring in extremely low birthweight infants are presented. Both infants experienced unilateral renal ischaemia resulting in hyponatraemia and hypertension. A proposed pathophysiological mechanism, namely unilateral renal ischaemia leading to a pressure‐natriuresis in the contralateral kidney, is presented. This is associated with an increase in plasma renin and aldosterone, with a paradoxical increase in urinary sodium loss. Immature renal tubular function and relative aldosterone resistance could place the extremely low birthweight infant at increased risk for the condition. The paucity of reports suggests that the condition might be under‐recognized.
ISSN:1034-4810
1440-1754
DOI:10.1046/j.1440-1754.2003.00142.x