Plasma renin activity (PRA) was determined in 10 children with acute glomerulonephritis and in 10 with the haemolytic-uraemic syndrome (HUS). Low renin levels were found in the hypertensive children with acute nephritis, all of whom had evidence of fluid overload. The amount of this overload correlated directly with the degree of hypertension and inversely with PRA. All the hypertensive children with HUS had high levels of plasma renin, and the highest levels were found in those cases who were subsequently shown to have the more severe degree of renal arteriolar occlusion. The findings emphasize the importance of measures designed to reduce salt and water overloading in the management of hypertension in acute nephritis, while drugs which suppress plasma renin are more likely to control blood pressure in HUS. Estimation of PRA may provide a guide to the management of hypertension in acute renal insufficiency.
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