Renal artery aneurysm as a cause of secondary hypertension in a preschooler

Abstract

Secondary hypertension is more frequent at early ages, with renovascular pathology being a significant cause. Renal artery aneurysms are rare and can be treated through endovascular therapy or may require surgical management with nephrectomy in selected cases.

Objective: To describe an uncommon case of hypertension secondary to a renal artery aneurysm, and to discuss its management and evolution.

Clinical Case: A 5-year-old male patient, previously asymptomatic, presented to the Emergency Department with a hypertensive crisis. An etiological study, including an abdominal CT angiography, revealed a fusiform aneurysm of the right renal artery. Antihypertensive treatment was initiated, but blood pressure control was inadequate, so a right unilateral nephrectomy was performed. The patient evolved normotensive without the use of medications and maintained follow-up with nephrology.

Conclusion: Secondary hypertension in pediatrics requires a comprehensive etiological study, as it can be asymptomatic even in secondary cases. Determining its cause allows for targeted treatment and the prevention of possible complications, such as aneurysm rupture. Furthermore, it is important for surgical solitary kidney patients to continue follow-up with nephrology.