Here, we report the case of a forty-year-old man with a history of very low birth weight (VLBW) (1300 g) who had hypertensive emergency (233/142 mmHg), acute kidney injury (AKI) (serum creatinine, 8.47 mg/dL), elevated plasma renin activity (102 ng/mL/h), and posterior reversible encephalopathy syndrome. Here, REN is linked to Posterior Leukoencephalopathy Syndrome.