Keywords
Hypertension, Pulmonary
Infant, Newborn
How to Cite
Abstract
Introduction: severe neonatal hydronephrosis is a congenital anomaly that can lead to renal and systemic complications. Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition that can worsen clinical prognosis. This case report describes the evolution of a neonate with severe hydronephrosis and PPHN, emphasizing the importance of a multidisciplinary approach.
Case Report: a full-term newborn was prenatally diagnosed with mild left renal pelvis dilation. At birth, he presented severe respiratory distress, requiring intubation and high-frequency oscillatory ventilation with inhaled nitric oxide. PPHN was diagnosed via echocardiography. Hemodynamic support and empirical antibiotic therapy were initiated. On day 4 of life, a percutaneous nephrostomy was performed, leading to progressive clinical improvement. Partial resolution of pulmonary hypertension and hemodynamic stability were documented. The patient remains under multidisciplinary follow-up by nephrology, urology, and neonatology.
Conclusions: severe neonatal hydronephrosis can be associated with PPHN, which can complicate clinical management. Early identification and appropriate surgical intervention are key to improving patient outcomes. A multidisciplinary approach optimizes clinical results and reduces long-term complications.
References
Carlström M. Hydronephrosis and risk of later development of hypertension. Acta Paediatr 2019; 108(1):50-7. doi: 10.1111/apa.14482
Cyphers E, Gaballah M, Acord M, Worede F, Srinivasan A, Vatsky S, et al. Percutaneous nephrostomy in neonates and young infants. J Vasc Interv Radiol 2023; 34(10):1815-21. doi: 10.1016/j.jvir.2023.06.017
Márquez H, Ríos D, Jean Tron M, Barajas L. Use of sildenafil for pulmonary hypertension in neonates. Bol Med Hosp Infant Mex 2020; 77(4):202-6. doi: 10.24875/BMHIM.20000041
Gu S, Yang X, Zhai Y, Xu W, Guo W, Shen T. Clinical characteristics of patients with prenatal hydronephrosis in early postnatal period: a single center retrospective study. BMC Pediatr 2023; 23(1):235. doi: 10.1186/s12887-023-04063-5
Chen Z, Lin H, Xu M, Xu G, Fang X, He L, et al. The clinical manifestations of intermittent hydronephrosis and their relationship with renal function in pediatric patients. J Pediatr Urol 2020; 16(4):458.e1-6. doi: 10.1016/j.jpurol.2020.04.026
Taydaş O, Ünal E, Akıncı D, Şeker M, Topçuoğlu O, Akhan O, et al. Percutaneous nephrostomy in infants: a 20-year single-center experience. Diagn Interv Radiol 2024; 30(5):318-24. doi: 10.4274/dir.2023.232276
Ključevšek T, Pirnovar V, Ključevšek D. Percutaneous nephrostomy in the neonatal period: indications, complications, and outcome-a single centre experience. Cardiovasc Intervent Radiol 2020; 43(9):1323-8. doi: 10.1007/s00270-020-02528-z
Annich G, Lynch W, MacLaren G, Wilson J, Bartlett R. ECMO: Extracorporeal Cardiopulmonary Support in Critical Care. Seattle: University of Washington Press, 2018
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Archives of Pediatrics of Uruguay