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

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.