Abstract:

Objective To explore the clinical features and diagnosis and treatment strategies of secondary pseudo-hypoaldosteronism (PHA). Methods Clinical characteristics, diagnostic approach and prognosis of a PHA patient caused by urinary tract anomaly combined with infection were retrospectively analyzed. Relevant literatures were reviewed. Results A 3-month-old male infant with hydronephrosis at 24 weeks of gestation was surgically treated with laparoscopic left pyeloureteroplasty and left nephropexy under general anesthesia at 2 months of age on June 15, 2022. The ureteral stent was removed on August 18, 2022. During the period of urinary tract infection on July 22 and September 12, 2022, he presented with hyponatremia, hyperkalemia and metabolic acidosis, accompanied by high renin and aldosterone levels. After active anti-infection and symptomatic treatment, re-examinations of blood sodium, blood potassium and blood gas analysis showed normal findings, and the levels of renin and aldosterone returned to normal. Conclusion Symptoms of mineralocorticoid resistance in children, such as hyperkalemia, hyponatremia and elevated aldosterone levels, pseudo-hypoaldosteronism alert a differentiation with PHA. Notably, the possibility of secondary PHA due to urinary tract infection and urinary system malformations should be concerned. For this disease, it is necessary to actively address urinary system malformations, control infections and maintain the stability of the internal environment.

Key words: pseudohypoaldosteronism, secondary, child, urinary tract infection