Persistent arterial hypotension after bilateral nephrectomy in a 4-month-old infant.
A patient with congenital nephrotic syndrome underwent bilateral nephrectomy at the age of 4 months. She showed persistent hypotension from the fourth postoperative day until death at the age of nearly 5 months. No cause for the hypotension could be found. It is postulated that, especially in young infants, a deficiency of renin after bilateral nephrectomy may cause persistent hypotension. An explanation for the putative increased risk of this complication in young infants may be their need for a highly active renin-angiotensin system. Until more is known about the incidence of this complication and its predisposing factors, reluctancy towards the performance of bilateral nephrectomy in children under the age of 6 months is warranted.
van Lieburg
A F
AF
Department of Pediatrics, University Medical Centre, Nijmegen, The Netherlands. A.vanlieburg@ckskg.azn.nl
Monnens
L A
LA
D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007223:Infant; D009392:Nephrectomy / Q000009:adverse effects*; D009404:Nephrotic Syndrome / Q000151:congenital* / Q000601:surgery*; D012083:Renin / Q000378:metabolism; D014057:Tomography, X-Ray Computed
D012083:Renin