Renin-dependent renovascular hypertension in infant with abdominal aortic atresia

A newborn infant was seen with severe and progressive arterial hypertension, congenital atresia of the abdominal aorta, and a renal venous renin activity ratio greater that 1:1.5 (1:3.1). Preoperative studies indicated that the renin-angiotensin axis was responsible for the production and maintenance of the severe hypertensive process. Right nephrectomy cured the arterial hypertension both above and below the area of coarctation. The possible roles of the pathogenic mechanism are discussed.