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Hyponatremic hypertensive syndrome in an obese man with renal ischemia

Khawer Saeed1

  • 1Division of Nephrology, King Abdul Aziz Hospital, Makkah, Saudi Arabia. ksaeed20@hotmail.com

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|September 15, 2006
PubMed

Insights

Hyponatremic-hypertensive syndrome, a rare electrolyte disorder, can present with severe hypertension and low sodium. This case highlights its occurrence in a 45-year-old man, emphasizing the need for prompt diagnosis.

Area of Science:

  • Nephrology
  • Endocrinology
  • Internal Medicine

Background:

  • Renovascular hypertension can present with electrolyte imbalances, notably hyponatremia.
  • The hyponatremic-hypertensive syndrome, characterized by low serum sodium and elevated blood pressure, was previously primarily documented in pediatric cases.

Observation:

  • A 45-year-old man presented with profound weakness, confusion, severe hypertension, and critically low serum sodium and potassium levels.
  • Initial management with captopril for hypertension led to renal function decline, necessitating its discontinuation.

Findings:

  • Diagnostic workup, including Color Doppler renal ultrasound and magnetic resonance angiography, confirmed bilateral renal artery stenosis.
  • The patient's clinical presentation and diagnostic findings were consistent with hyponatremic-hypertensive syndrome in an adult.

Implications:

  • This case underscores that hyponatremic-hypertensive syndrome can occur in adults, not just children.
  • Prompt identification and management of renal artery stenosis are crucial for resolving severe hypertension and electrolyte disturbances.
  • Highlights the importance of considering renovascular causes in patients with unexplained severe hypertension and hyponatremia.

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