Abstract
Elevation of plasma renin activity (PRA) has been reported with several kidney tumors, but not with mesoblastic nephroma (MN), a common renal tumor of early infancy. We have studied a 3 month old infant with a large intrarenal mass, histologically characterized as MN. Prior to removal of the tumor, the infant exhibited severe hypertension, and moderate hypokalemia. PRA from peripheral veins, aorta, and inferior vena cava, below the renal vein were markedly elevated to greater than 300 ng/ml/hour. Massive amounts of “Big Renin”, greater than 1000 ng/ml/3 hour were also demonstrated. Normalization of blood pressure and serum potassium occurred shortly after removal of the renal mass, and PRA and “Big Renin” returned to basal levels. There is no evidence of tumor recurrence and serial measurements of PRA over a 12 month period shows levels below 5 ng/ml/hour and “Big Renin” remains undetectable. Also, in repeated studies, expansion of plasma volume resulted in suppression of PRA, demonstrating normal regulation of renin release. These observations suggest: (1) Mesoblastic nephroma may be associated with autonomous production of PRA, producing hypertension and hypokalemia; and (2) Serial measurements of PRA may be a useful biologic marker for detection of early recurrence of the tumor.
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Groshong, T., Miles, J., Bauer, J. et al. ELEVATED PLASMA RENIN ACTIVITY AND “BIG RENIN” IN MESOBLASTIC NEPHROMA. Pediatr Res 11, 551 (1977). https://doi.org/10.1203/00006450-197704000-01088
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DOI: https://doi.org/10.1203/00006450-197704000-01088
