scholarly journals OP06.02: Fetal multicystic dysplastic kidney: prenatal compensatory renal growth pattern, associated anomalies and postnatal outcome

2019 ◽  
Vol 54 (S1) ◽  
pp. 101-102
Author(s):  
N. Gilad ◽  
A. Weissmann‐Brenner ◽  
B. Dekel ◽  
R. Achiron ◽  
Y. Gilboa ◽  
...  
1994 ◽  
Vol 266 (4) ◽  
pp. F628-F632 ◽  
Author(s):  
A. Haramati ◽  
M. D. Lumpkin ◽  
S. E. Mulroney

Removal of one kidney results, within days, in accelerated growth of the remaining kidney. However, the mechanisms that underlie this compensatory renal hypertrophic response, particularly in the early time period following nephrectomy, are not understood. In this study we tested the hypothesis that removal of one kidney leads to a change in the pulsatile release of growth hormone (GH), which facilitates compensatory renal growth. Adult Wistar rats were implanted with Silastic cannulas in jugular veins and underwent either unilateral nephrectomy (UNX) or sham operation. Plasma levels of GH were determined 24 and 48 h after sham operation or UNX. Blood samples were taken every 20 min over a 6-h period from conscious, unrestrained animals. Pulsatile GH release was markedly elevated 24 h after UNX in both the amplitude of the surges as well as in the duration of release. Peak GH levels after 24 h were three- to fourfold higher in UNX rats compared with sham controls (417 +/- 75 vs. 119 +/- 23 ng/ml, P < 0.05). However, this enhanced release of GH appeared to be of short duration and began declining by 48 h post-UNX (peak level of 227 +/- 37 ng/ml, P < 0.05 vs. both 24 h UNX and sham controls). To examine whether this rise in GH release post-UNX contributed to the compensatory renal growth, rats underwent UNX and were immediately treated with an antagonist to GH-releasing factor (GRF-AN; i.e., [N-Ac-Tyr1,D-Arg2]GRF-(1-29) amide, 200 micrograms/kg twice daily), and the effects on GH release and renal growth were determined. Administration of GRF-AN significantly suppressed the increase in GH release post-UNX and was associated with a significant attenuation in renal growth 48 h post-UNX in GRF-AN-treated rats (8.7 +/- 2.6% vs. 22.7 +/- 3.0% in UNX controls, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Author(s):  
Tian-Jian Chen ◽  
Renfang Song ◽  
Adam Janssen ◽  
Ihor V. Yosypiv

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Satoshi Ieiri ◽  
Kouji Nagata

Abstract Background Pediatric hydronephrosis induced by pelvic-ureteric junction obstruction (PUJO) is treated by dismembered pyeloplasty (DP) via open and laparoscopic surgery. The etiology of PUJO involves both intrinsic stenosis and extrinsic compression of crossing vessels (CVs). PUJO owing to CVs is also treated by DP, as there is no consensus concerning this vascular condition. We encountered a 2-year-old infant with pure extrinsic PUJO combined with horseshoe kidney who successfully underwent laparoscopic transposition for CVs (vascular hitch). Case presentation A 2-year-old boy was prenatally diagnosed with left multicystic dysplastic kidney (MDCK) and right hydronephrosis and received a definitive diagnosis after birth. At 6 months old, renal scintigraphy revealed a non-functioning pattern in the left kidney and an obstructive pattern in the right, showing no response to furosemide loading. The patient also had recurrent urinary tract infection, and his right hydronephrosis gradually worsened. We decided to perform surgery for the right PUJO. Preoperative enhanced computed tomography detected three right renal vessels independently branching from the abdominal aorta. The middle renal vessels were located at the ventral side of the pelvis and coincident with the site of PUJO. These vessels were suspected of being CVs. The patient underwent laparoscopic surgery electively. A 5-mm trocar was inserted at the umbilicus for a 5-mm, 30° rigid scope. Two additional ports were then inserted under laparoscope inspection. The dilated right pelvis and CVs were detected after ascending colon mobilization. To confirm the pathogenesis of PUJO, the CVs were dissected and taped. After taping the CVs, an intraoperative diuretic test was performed using furosemide loading. Peristalsis of the right ureter was recognized, and the extrinsic PUJO owing to the CVs was definitively confirmed. We therefore performed transposition for the CVs (vascular hitch procedure). The CVs were mobilized in the cranial direction and those were wrapped by dilated pelvis. The post-operative course was uneventful. The renal scintigraphy findings improved and showed a favorable response of furosemide loading. Conclusions The laparoscopic vascular hitch procedure is minimally invasive and effective for extrinsic PUJO due to CVs. Anastomotic stricture after Anderson and Hynes DP can be prevented by appropriate patient selection.


Renal Failure ◽  
2005 ◽  
Vol 27 (2) ◽  
pp. 189-192 ◽  
Author(s):  
Said Al-Ghwery ◽  
Abdulrahman Al-Asmari

2003 ◽  
pp. 809-816
Author(s):  
David Thomas ◽  
Azad Najmaldin

1992 ◽  
Vol 33 (6) ◽  
pp. 566-568 ◽  
Author(s):  
P. Prassopoulos ◽  
N. Gourtsoyiannis ◽  
D. Cavouras ◽  
N. Pantelidis

In 27 patients nephrectoraized for renal carcinoma, the compensatory hypertrophy of the remaining kidney was assessed by 72 CT examinations performed one month before and during 32 months after nephrectomy. Kidney size was estimated on CT by multiple measurements of the renal parenchymal thickness. Kidney growth was evaluated by comparing the amount of renal parenchyma before and after contralateral nephrectomy. Renal compensatory hypertrophy varied with postnephrectomy time. Kidney enlargement was 15% in the first 3 months, reached maximum 30% about a year later, and was reduced to 5%, 2 1/2 years postoperatively.


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