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

Yael Kovalski, Roxana Cleper, Irit Krause, Benjamin Dekel, Alexander Belenky, Miriam Davidovits

Research output: Contribution to journalArticlepeer-review


Background Hyponatremic hypertensive syndrome (HHS) is characterized by unilateral renal artery stenosis with secondary hypertension and glomerular and tubular dysfunction due to hyperfiltration and activation of the renin-angiotensin system (RAS). Case-diagnosis/treatment We describe four children with HHS. All presented with polyuria and polydipsia, electrolyte disturbances,metabolic alkalosis, variable tubular dysfunction, and nephrotic range proteinuria along with hypertension. Interestingly, in one patient, glomerular and tubular abnormalities preceded the development of hypertension. All symptoms resolved after the underlying renal ischemia was corrected by percutaneous angioplasty. Conclusion Hyponatremic hypertensive syndrome may be more common in children than previously thought. Clinicians should be alert of the signs and symptoms because cure is possible with timely diagnosis and treatment.

Original languageEnglish
Pages (from-to)1037-1040
Number of pages4
JournalPediatric Nephrology
Issue number6
StatePublished - Jun 2012


  • Hypertension
  • Hyponatremic hypertensive syndrome
  • Proteinuria
  • Renal artery stenosis
  • Renin-angiotensin system
  • Tubular dysfunction

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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