An unusual case of renal medullary hyperechogenicity and hypertension: question

Excerpt

This was the first newborn of a non-consanguineous, young and healthy couple. At 35 weeks of gestation, prenatal sonography revealed oligohydramnios and normal dimensions of the kidneys, with medullary hyperechogenicity suggesting medullary nephrocalcinosis (MN) (Fig. 1)

. A 2,720 g premature boy was delivered at 35 weeks by cesarean section. The Apgar scores were 9 and 10 at the 1st and 10th minute, respectively. Congenital malformations were not apparent. At 12 h of age he developed a small spontaneous pneumothorax and needed non-invasive ventilator support for the first 2 days of life. Reduced urinary output in the first 24 h responded to one treatment with furosemide. An ultrasound performed on the second day of his life showed medullary hyperechogenicity, confirming the prenatal ultrasound signs suggestive of medullary nephrocalcinosis, and slightly enlarged kidneys. The length of the right kidney was 42 mm, that of the left kidney was 52 mm [>2 standard deviation scores (SDSs) of mean length for 35 weeks of gestation] [1]. The serum creatinine and urinalysis results were normal. He was discharged home on the 10th postnatal day and referred to the pediatric nephrology clinic. …