HYPERTENSION

Hypertension is commonly associated with Wilms tumor, but hypertension secondary to renin screting Wilms tumor is uncommon. We present an infant with severe hypertension and renin hypertension, which we resistant to multiple antihypertensive agents. blood pressure was eventually controlled with a combination of captopril and losartan.
Hypertension  in patients with Wilms tumor is relatively common. Sukarochana et al. reviewed 46 patients with Wilms tumor from the Children's hospital of pittsburgh and found that 63% had hypertension. Hypertension is usually due to intra renal ischemia secondary to compression of the normal renal vasculature, resulting in increased renin production. Nephrectomy normalized blood pressure in all cases. autonomous renin secretion by Wilms tumor has also been described. In some patients, hyponatremia may also occur. Silberman and blau reported a child who had a Wilms tumor, malignant hypertension, polydipsia, hyponatremia, and elevated levels of atrial natriuretic peptide ( ANP ). A number of others have also reported renin secreting Wilms tumors.
Although the devinitive management of renin producing Wilms tumors is nephrectomy, pre operative stabilization of blood pressure is essential for a successful outcome.

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