Treatment of malignant hypertension with infusion of sodium chloride; A case report and a review.

Kuroda, Hiroshi; Yamauchi, Toshiyuki; Murata, Toyoaki; Matsumoto, Jun; Haruyama, Takeshi

doi:10.1620/tjem.132.179

Cited by 14 publications

(7 citation statements)

References 9 publications

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“…There was a gradual decline in blood pressure in this patient, different from the potentially dangerous fall which can be seen with angiotensin-converting enzyme (ACE) inhibitors [19]. With severe volume depletion, cautious repletion is needed, which can probably also reduce arterial pressure by suppression of RAAS [20]. …”

Section: Discussionmentioning

confidence: 99%

The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels

Tellingen

Lilien²,

Bruinenberg³

et al. 2011

International Journal of Nephrology

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Objective. To report the irreversible severe neurological symptoms following the hyponatremic hypertensive syndrome (HHS) in an infant after umbilical arterial catheterization. Design. Case report with review of the literature. Setting. Neonatal intensive care unit at a tertiary care children's hospital. Patient. A three-week-old preterm infant. Conclusions. In evaluating a neonate with hyponatremia and hypertension, HHS should be considered, especially in case of umbilical arterial catheterization. In case of diagnostic delay, there is a risk of severe irreversible neurological damage.

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Section: Discussionmentioning

confidence: 99%

The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels

Tellingen

Lilien²,

Bruinenberg³

et al. 2011

International Journal of Nephrology

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“…Under these circumstances a vigorous and potentially dangerous fall in blood pressure has been observed in adults [32,33] and a child [19] with the first dose of an angiotensinconverting enzyme (ACE) inhibitor. Indeed, where volume depletion is severe, cautious volume repletion with intravenous isotonic saline can, as in clinical and experimental malignant hypertension [34,35], reduce arterial pressure (presumably through suppression of the activated reninangiotensin system) after which an ACE inhibitor or angiotensin receptor blocker can more safely be administered [36]. Alternative or additional antihypertensive agents may be chosen but clearly, potent diuretics are likely to exacerbate, rather than ameliorate, the disorder.…”

Section: Managementmentioning

confidence: 99%

Unilateral renal ischemia causing the hyponatremic hypertensive syndrome in children—more common than we think?

Nicholls

2006

Pediatr Nephrol

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A case report in the journal Pediatric Nephrology describes a 15-month-old girl with the syndrome of hypertension and hyponatremia (HH syndrome) due to underlying unilateral renal artery stenosis. This syndrome is typically associated with hypokalemia and severe volume depletion and sometimes proteinuria, all of which, along with hypertension and hyponatremia, are usually corrected by resolution of the underlying renal ischemia. Gross and probably sudden activation of the renin-angiotensin system in response to renal ischemia is central to the pathophysiology although the cardiac atrial and B-type natriuretic peptides probably contribute also. Initial control of the severe hypertension may, in some cases, require careful volume repletion prior to introduction of blockade of the renin-angiotensin system in order to avoid first-dose hypotension, after which correction of the underlying renal ischemia is required. Whereas the syndrome has rarely been reported in children, it is possible that, as in adults, this reflects its lack of recognition by clinicians. The HH syndrome due to unilateral renal ischemia in children may be much more common than we think.

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“…These factors increase the glomerular pressure and promote sudden natriuresis, which in turn stimulates the release of renin and sets the vicious circle in motion. The course of malignant hypertension has been shown to slow down after administration of a saline load [7]. The course of malignant hypertension has been shown to slow down after administration of a saline load [7].…”

Section: Accelerated and Malignant Hypertensionmentioning

confidence: 99%

Hypertensive Crises

Ram

Hyman

1987

J Intensive Care Med

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Hypertensive crises are a group of medical conditions in which a rapid decrease in blood pressure is necessary to prevent serious complications. Although uncommon in clinical practice, a hypertensive crisis should be recognized and treated promptly. Any form of hypertension may be associated with hypertensive crisis, the main determinant being the level of blood pressure rather than the cause of hypertension. In certain clinical situations the abruptness with which the blood pressure increases seems to be more important than the absolute level of blood pressure in causing the hypertensive crisis (e.g., toxemia of pregnancy in women and acute onset of hypertension in children with acute glomerulonephritis). In other clinical situations the absolute level of blood pressure does not affect the seriousness of hypertension so much as coexisting complications that may make even moderate hypertension dangerous (e.g., acute aortic dissection and acute left ventricular failure ).

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Treatment of malignant hypertension with infusion of sodium chloride; A case report and a review.

Cited by 14 publications

References 9 publications

The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels

The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels

Unilateral renal ischemia causing the hyponatremic hypertensive syndrome in children—more common than we think?

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