![]() ![]() Prevalence of hypertension in children is about 2.5–3%, with some studies suggesting an increasing trend, making elevated blood pressure one of the most common conditions in childhood ( 1). We also discuss important points in the management of children presenting with renin-mediated hypertension. In this paper, we present the case of reninoma in an adolescent girl emphasizing clinical presentation, diagnostic evaluation, and medical and surgical treatment of this rare tumor. Nephron-sparing surgery is curative with maintenance of normal blood pressure after discontinuation of antihypertensive medications in the majority of patients. Renal vein renin sampling with lateralization might help to identify the site of excessive renin production. While renal ultrasound can miss reninoma, contrast CT or magnetic resonance imaging of the kidneys are diagnostic modalities of choice leading to the correct diagnosis. Diagnostic imaging is employed to identify the source of excessive renin production. Elevated blood levels of renin and aldosterone confirm the clinical suspicion of renin-mediated hypertension. The clue to clinical diagnosis is the presence of hypokalemia and metabolic alkalosis on the first blood sample drawn before any treatment is instituted. Patients typically present with a long history of headaches leading to a diagnosis of severe hypertension that responds well to antihypertensive treatment targeting the renin-angiotensin-aldosterone system. Reninomas are usually diagnosed in adolescents and young adults with occasional reports in younger children. Reninoma (juxtaglomerular cell tumor) is a rare cause of renin-mediated hypertension. 5Department of Paediatric Surgery, Royal Children’s Hospital, Brisbane, QLD, Australia.4Department of Pathology, Mater Adult Hospital, Brisbane, QLD, Australia.3Department of Medical Imaging, Mater Children’s Hospital, Brisbane, QLD, Australia.2Department of Paediatrics, Mater Children’s Hospital, Brisbane, QLD, Australia.1Department of Paediatrics and Child Health, The University of Queensland, Brisbane, QLD, Australia.Peter Trnka 1,2*, Luisa Orellana 2, Mark Walsh 3, Louis Pool 4 and Peter Borzi 1,5
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