Secondary pseudohypoaldosternism. Review of the literature and experience in a Pediatric Nephrology Unit.

Abstract

Abstract BACKGROUND: Secondary pseudohypoaldosteronism (S-PHA) is a rare entity that appears due to the resistance of the renal tubule to the action of aldosterone in children with urinary tract infection and/or nephrourological malformation. METHODS: Retrospective observational descriptive study of cases diagnosed with secondary pseudohypoaldosteronism from a Pediatric Nephrology Unit for 14 years. Review of the bibliography of the last 10 years. RESULTS: A sample of 12 patients has been obtained. The most frequent reason for consultation was the loss of weight (50%). Sixty-seven percent of the patients associated urinary tract infection. Ninety-two percent of them had an underlying nephrourological pathology, and 60% were admitted to the Pediatric Intensive Care Unit. One patient presented neurological sequelae because of a subsequent pontine myelinosis. Twenty-one articles have been registered in PubMed: 9 clinical case reports, 3 bibliographic reviews and 9 case series. CONCLUSIONS: There is little evidence and consequently a lack of knowledge of secondary pseudohypoaldosteronism. It usually appears with non-specific symptoms, so we sholud know its typical hydroelectrolytic changes to establish a clinical suspicion, to be able to offer early medical and surgical treatment to avoid life-threatening complications.