Related Experiment Video

Updated: May 24, 2026

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
04:12

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats

Published on: March 28, 2025

Hyponatremic hypertensive syndrome in pediatric patients: is it really so rare?

Yael Kovalski1, Roxana Cleper, Irit Krause

  • 1Institute of Pediatric Nephrology, Schneider Children's Medical Center of Israel, Petach Tikva, 49202, Israel.

Pediatric Nephrology (Berlin, Germany)
|February 28, 2012
PubMed

Insights

Hyponatremic hypertensive syndrome (HHS) in children presents with polyuria, polydipsia, and hypertension. Timely diagnosis and percutaneous angioplasty can cure this condition, suggesting it may be more common than previously recognized.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Endocrinology

Background:

  • Hyponatremic hypertensive syndrome (HHS) involves unilateral renal artery stenosis, leading to secondary hypertension and renal dysfunction via hyperfiltration and renin-angiotensin system (RAS) activation.
  • Understanding the pathophysiology of HHS is crucial for diagnosing and managing pediatric hypertension.
  • The renin-angiotensin system plays a key role in the development of hypertension in HHS.

Observation:

  • Four pediatric cases of HHS are presented, exhibiting polyuria, polydipsia, electrolyte imbalances, metabolic alkalosis, and nephrotic-range proteinuria.
  • In one case, glomerular and tubular abnormalities were observed preceding the onset of hypertension.
  • Clinical presentation of HHS can be variable, including significant renal dysfunction.

Findings:

  • Successful treatment of renal ischemia via percutaneous angioplasty led to the resolution of all HHS symptoms in the described cases.
  • Percutaneous angioplasty is an effective treatment for correcting the underlying cause of HHS.
  • Complete recovery from HHS is achievable with appropriate intervention.

Implications:

  • HHS may be underdiagnosed in the pediatric population.
  • Clinicians should maintain a high index of suspicion for HHS in children presenting with relevant symptoms.
  • Early diagnosis and prompt treatment of renal artery stenosis can lead to a cure for HHS.
Abstract

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Diabetes Insipidus I: Introduction01:29

Diabetes Insipidus I: Introduction

Definition Diabetes insipidus is a disorder marked by the production of large amounts of dilute urine because of impaired vasopressin production, release, or kidney response. The lack of effective vasopressin action limits water reabsorption in the renal collecting ducts, which leads to excessive urinary water loss and intense thirst.Clinical PresentationIndividuals with diabetes insipidus report persistent thirst and very high urine output. In severe cases, fluid intake can reach up to 20...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...