Severe Renal Hypertension in a 16 year old Patient, A Case Report.
  G. Cortina, L.B. Zimmerhackl
  Introduction: Arterial Hypertension in Childhood is in over 80% a primary hypertension due to an underlying disease, mostly of renal origin.

Patient: A 16 year old girl is seen at the ophtalmic clinic because of vision problems. Because of a Fundus hypertonicus she is transferred to the Pediatric Clinic. No family history of hypertension or kidney diseases are known.

Findings: Admission findings: Blood pressure: 213/150 mmHg. Urea: 131,9 mg/dl, Creatinine: 6,62 mg/dl. Protein Creatinine Ratio: 6,79 g/gCrea.
The Kindney ultrasound showed a severe parenchymatous damage of both kidneys. The MRI showed no evidence of a stenoses of the kidney arterias. The Echocardiography showed a left-ventricular myocardial hypertrophie and the ophtalmologic examination a Fundus hypertonicus Level III.
Serological findings: HBs AG pos, HBs IgG pos.

Diagnosis: Severe hypertension due to chronic renal failure of unknown origine.

Course: The patient is treated with a combined antihypertensive medication composed of a calcium chanell blocker, a Beta Adrenoreceptor antagonist and a Diuretic (Nifedipine retard 20mg 2x1; Metopropol 100mg 2x1 and Furosemid 20mg 3x1). With this Therapie the Blood Pressure is high normal: 135/85 mmHg. Three months after beginning of the treatment the ophtalmological findings have been partly reversed. The patient is currently evaluated for kidney transplantation.