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Pediatric hyponatremic hypertensive syndrome

Amira Peco-Antic

Hyponatremic hypertensive syndrome is an important complication of severe arterial hypertension with the potential for significant morbidity and mortality. It is recognized by the association of the clinical signs and symptoms of hyponatremia and hypertension accompanied by inappropriately high urinary output and electrolyte losses. According to the available literature there are data for only 20 children with the syndrome; 15 of which had underlying renovascular disease, most commonly due to fibromuscular dysplasia of renal arteries. Stimulation of the renin–angiotensin system from the ischemic kidney seems to play an essential role in the pathogenesis of hyponatremic hypertensive syndrome. The outcome if untreated is poor. However, if recognized in time and appropriately treated, it can sometimes be cured. The aim of this paper is to raise awareness of this hypertensive complication in children to insure that it is appropriately investigated and treated.