Renal artery stenosis and nephrotic syndrome: a rare combination in an infant

被引:0
作者
Mia E. Lang
Manjula Gowrishankar
机构
[1] University of Alberta Hospitals,Division of Pediatric Nephrology, Department of Pediatrics
来源
Pediatric Nephrology | 2003年 / 18卷
关键词
Infant; Hypertension; Proteinuria; Renin; Fibromuscular dysplasia; Nephrotic syndrome;
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学科分类号
摘要
We describe an uncommon pediatric finding of unilateral renal artery stenosis, which presented as nephrotic syndrome, hypertension, failure to thrive, and hyponatremia. The child was a previously well 8–month-old male who looked well but had mild periorbital edema with severe hypertension. After 3 days of captopril therapy, the nephrotic–range proteinuria significantly improved. However, the hypertension persisted. Renal imaging revealed a small left kidney with reduced parenchymal uptake and no significant excretion. A renal angiogram demonstrated left renal artery stenosis with increased left renal vein renin activity. The hypertension resolved within 24 h of a left nephrectomy, but non-nephrotic–range proteinuria persisted for 8 months post operatively. Pathology of the left kidney was consistent with fibromuscular dysplasia. Although a few glomeruli (1%) had changes consistent with focal segmental glomerulosclerosis, such a few abnormal glomeruli were unlikely to account for the nephrotic syndrome. Hypertension–induced changes in the unaffected right kidney probably caused the nephrotic–range proteinuria.
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页码:276 / 279
页数:3
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