In renovascular hypertension due to neonatal umbilical artery catheterization, which hormones are elevated?

• A. Renin only
• B. Renin and aldosterone
• C. Aldosterone only
• D. ADH

Answer: (B)

Renovascular hypertension from renal artery injury reduces blood flow to the kidney, which directly stimulates the juxtaglomerular cells to release renin. More renin increases angiotensin II, which in turn drives aldosterone secretion from the adrenal cortex. The combination of increased renin and aldosterone is the hallmark of secondary hyperreninemic hyperaldosteronism seen in renovascular hypertension, such as after neonatal umbilical artery catheter–related renal artery injury. ADH is not the primary hormone elevated in this scenario, so the key finding is elevated renin with elevated aldosterone.