Journals / Marmara Medical Journal / 2026 / Volume: 30 Issue: 2

Salt wasting in two neonates with posterior urethral valves: secondary pseudohypoaldosteronism

Posterior üretral valvlı iki yenidoğanda tuz kaybı: sekonder psödohipoaldosteronizm

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Publication Date
2017-05-14
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Herein, we present two patients with secondary PHA caused by posterior urethral valves.

📌 3 Key Takeaways

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Objective & Hypothesis:Secondary pseudohypoaldosteronism (PHA) is a rare condition that presents with hyperkalemia, hyponatremia, and metabolic acidosis, which develops due to renal tubular unresponsiveness to aldosterone.
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Key Findings & Data:Besides other findings, diagnosis is established with highly increased plasma aldosterone and renin levels.
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Conclusion & Impact:Herein, we present two patients with secondary PHA caused by posterior urethral valves.
🔬Design:Case Report
📍Scope:Comprehensive Sample
⚙️Variables:Obstructive uropathy · Secondary pseudohypoaldosteronism · Infant

Abstract

Secondary pseudohypoaldosteronism (PHA) is a rare condition that presents with hyperkalemia, hyponatremia, and metabolic acidosis, which develops due to renal tubular unresponsiveness to aldosterone. It may be seen in infants with obstructive uropathy and acute pyelonephritis. Three important reasons of the aldosterone unresponsiveness of the tubules are early infancy kidney, obstructive uropathy, and urinary tract infection. Besides other findings, diagnosis is established with highly increased plasma aldosterone and renin levels. In infants who present with hyperkalemia, hyponatremia, and metabolic acidosis, PHA should be considered in the differential diagnosis of congenital adrenal hyperplasia. Urinary ultrasonography and urine analysis should be performed in these patients. Herein, we present two patients with secondary PHA caused by posterior urethral valves.

Özet

Sekonder psödohipoaldosteronizm (PHA), böbrek tübüllerinin aldosterona duyarsızlığı ile karakterize, hiperkalemi, hiponatremi ve metabolik asidoz ile kendini gösteren nadir bir durumdur. Obstrüktif üropatisi olan bebeklerde ve piyelonefrit sırasında görülebilir. Gelişimi devam eden erken bebeklik dönemi böbreği, üriner sistemin obstrüktif anomalisi ve enfeksiyonu sekonder PHA hastalarında tübüluslarda aldosteron direncine neden olan üç önemli faktördür. Genellikle hiponatremi, hiperkalemi ve metabolik asidoz ilk bulgulardır, tetkiklerde belirgin olarak yükselmiş plazma renin ve aldosteron seviyelerinin saptanması ile tanı konur. Süt çoçuklarında biyokimyasal incelemede hiperpotasemi, hiponatremi ve metabolik asidoz saptandığında konjenital adrenal hiperplazi ayırıcı tanısında PHA göz önünde bulundurulmalı ve bu hastalarda üriner ultrasonografisi (USG) ve idrar analizi rutin olarak yapılmalıdır. Bu yazımızda sekonder PHA gelişen posterior üretral valv (PUV)‘lı iki hasta sunuldu.

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Cite This Article

Altuntaş, Ü., Gökce, İ., Tuğtepe, H., Benzer, M., Güven, S., Yıldız, N., Alpay, H. (2017). Salt wasting in two neonates with posterior urethral valves: secondary pseudohypoaldosteronism. Marmara Medical Journal, Volume: 30 Issue: 2. https://doi.org/10.5472/marumj.344826

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References (11)

  1. Devuyst O, Konrad M, Jeunemaitre X, Zennaro MC. Tubular disorders of electrolyte regulation. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N, editors. Pediatric Nephrology. 6th ed. Berlin Heidelberg: Springer-Verlag, 2009; 929-77.
  2. Goodyer P. Disorders of tubular transport. In: Kher KK, Schnaper HW, Makker SP, editors. Clinical Pediatric Nephrology. 2nd ed. London: Informa Healthcare, 2006; 317-36.
  3. Nasir AA, Ameh EA, Abdur-Rahman LO, Adeniran JO, Abrahan MK. Posterior urethral valve. World J Pediatr 2011;7:205-16. doi: 10.1007/s12519-011-0289-1
  4. Hodges SJ, Patel B, McLorie G, Atala A. Posterior urethral valves. ScientificWorldJournal 2009; 9:1119-26. doi: 10.1100/tsw.2009.127
  5. Asano T, Abe M, Asai M, et al. Urinary tract malformation and infection with hyperkalemia and decreased fractional excretion of potassium in an infant. J Nippon Med Sch 2006;73:289-91. doi: http://doi.org/10.1272/jnms.73.289
  6. Bogdanović R, Stajić N, Putnik J, Paripović A. Transient type 1 pseudo- hypoaldosteronism: report on an eight-patient series and literature review. Pediatr Nephrol 2009;24:2167- 75. doi: 10.1007/s00467-009-1285-8
  7. Pai B, Shaw N, Högler W. Salt – losing crisis in infants – not always of adrenal origin. Eur J Pediatr 2012;171:317-21. doi: 10.1007/s00431-011-1541-3
  8. Nandagopal R, Vaidyanathan P, Kaplowitz P. Transient pseudohypoaldosteronism due to urinary tract infection in infancy: A report of 4 cases. Int J Pediatr Endocrinol 2009;2009:195728. doi: 10.1155/2009/195728
  9. Ağladıoğlu SY, Aycan Z, Kendirci HN, Erkek N, Baş VN. Does pseudohypoaldosteronism mask the diagnosis of congenital adrenal hyperplasia? J Clin Res Pediatr Endocrinol 2011; 3:219-21. doi:10.4274/jcrpe.369
  10. Bowden SA, Cozzi C, Hickey SE, Thrush DL, Astbury C, Nuthakki S. Autosomal dominant pseudohypoaldosteronism type 1 in an infant with salt wasting crisis associated with urinary tract infection and obstructive uropathy. Case Rep Endocrinol 2013;2013:524647. doi:http://dx.doi. org/10.1155/2013/524647
  11. Bayer M, Kutílek S. A hereditary form of pseudohypoaldosteronism may be manifested in the course of pyelonephritis. Acta Paediatr 1993; 82:504. doi: 10.1111/ j.1651-2227.1993.tb12736.x