Severe hypertension and massive proteinuria in a newborn with renal artery stenosis.

Renal vein thrombosis and the congenital nephrotic syndrome have been associated with nephrotic-range proteinuria/nephrotic syndrome and hypertension in the newborn period. We describe a newborn with severe hypertension and proteinuria secondary to unilateral renal artery stenosis. Proteinuria completely disappeared with blood pressure control (with sodium nitroprusside and an angiotensin-converting enzyme inhibitor). Although renin was not measured, we speculate that proteinuria might have been induced by a high renin state, and was controlled by the angiotensin-converting enzyme inhibitor.

[Normal values in pediatric nephrology]. / Les normes en néphrologie pédiatrique.

The presence of renal disease can be excluded on the basis of a few simple tests: some of them are performed at the bed side: the assessment of miction frequency and urine flow rate, urine analysis by dipstick, urine specific gravity and osmolality. All these simples tests provide valuable information. When suspected, a functional defect can be confirmed by analyzing the urinary excretion of urine solutes, such as proteins, glucose and electrolytes. Imaging studies such as ultrasonography and radioisotopic scintigraphy can define the size and the separate function of the kidneys. The assessment of blood pressure is mandatory in childhood, the more so when renal disease is suspected. Normal values for all these parameters vary as a function of age, body weight and body surface area. They are briefly described here.