A Case of Neonatal Hypertension with Chronic Kidney Disease Presenting as Anasarca, Hypoalbuminemia and Pulmonary Bleed

Incidence of hypertension is reported to be around 0.2% in healthy term newborns and up to 3% in the infants in Neonatal Intensive Care Units (NICUs). Neonatal Chronic Kidney Disease (CKD) is defined as a decrease in kidney function which manifests in the neonatal period. Neonatal CKD has an estimated incidence of 1 in 10,000 live births. The diagnosis of CKD in the neonatal period is typically made after a renal ultrasonogram, first performed in the prenatal period and repeated soon after birth. This case report is about a 22-days-old male neonate that presented with abdominal distension, generalised pitting oedema and hypertension. On day 33 of life, the baby developed pulmonary haemorrhage. A diagnosis of CKD was made, based on renal ultrasonogram along with urine microscopy and urine protein creatinine findings. Renal Doppler was not suggestive of renal artery stenosis or renal vein thrombosis. A 2D echo was not suggestive of coarctation of aorta or interrupted aortic arch. Ultrasonography of abdomen did not reveal any mass. Plasma renin levels were normal. Hypertension finally normalised on oral amlodipine. Baby has been normotensive on oral amlodipine during follow-up over the last six months. This is a rare case of hypertension with CKD presenting in the neonatal period.