UNILATERAL MULTICYSTIC KIDNEY IN INFANTS

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 769-781
Author(s):  
MARK M. RAVITCH ◽  
MARSHALL C. SANFORD
Keyword(s):  
Renal Function ◽  
Abdominal Mass ◽  
Progressive Increase ◽  
Contralateral Kidney ◽  
Multicystic Kidney

Four infants are reported with unilateral replacement of the kidney by large cysts. These cases and six similar ones found in the literature show: (a) a large abdominal mass producing pressure symptoms only; (b) a normal contralateral kidney; (c) progressive increase in size of the mass; (d) adequate renal function after resection of the involved kidney.

Loss of a kidney during fetal life: long-term consequences and lessons learned

2014 ◽  
Vol 306 (8) ◽  
pp. F791-F800 ◽  
Author(s):  
Yugeesh R. Lankadeva ◽  
Reetu R. Singh ◽  
Marianne Tare ◽  
Karen M. Moritz ◽  
Kate M. Denton
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Early Adulthood ◽  
Epidemiological Studies ◽  
Progressive Increase ◽  
Lessons Learned ◽  
Fetal Life ◽  
Unilateral Renal Agenesis ◽  
Multicystic Kidney

Epidemiological studies reveal that children born with a solitary functioning kidney (SFK) have a greater predisposition to develop renal insufficiency and hypertension in early adulthood. A congenital SFK is present in patients with unilateral renal agenesis or unilateral multicystic kidney dysplasia, leading to both structural and functional adaptations in the remaining kidney, which act to mitigate the reductions in glomerular filtration rate and sodium excretion that would otherwise ensue. To understand the mechanisms underlying the early development of renal insufficiency in children born with a SFK, we established a model of fetal uninephrectomy (uni-x) in sheep, a species that similar to humans complete nephrogenesis before birth. This model results in a 30% reduction in nephron number rather than 50%, due to compensatory nephrogenesis in the remaining kidney. Similar to children with a congenital SFK, uni-x sheep demonstrate a progressive increase in arterial pressure and a loss of renal function with aging. This review summarizes the compensatory changes in renal hemodynamics and tubular sodium handling that drive impairments in renal function and highlights the existence of sex differences in the functional adaptations following the loss of a kidney during fetal life.

Effects of growth hormone and IGF-I on renal function in rats with normal and reduced renal mass

1990 ◽  
Vol 259 (5) ◽  
pp. F747-F751 ◽  
Author(s):  
S. B. Miller ◽  
V. A. Hansen ◽  
M. R. Hammerman
Keyword(s):  
Growth Hormone ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Renal Mass ◽  
Filtration Rate ◽  
Inulin Clearance ◽  
Mass Reduction ◽  
Contralateral Kidney ◽  
Igf I

To characterize actions of growth hormone (GH) and insulin-like growth factor ( (IGF-I) on renal function in rats with normal and reduced renal mass, we administered recombinant bovine growth hormone (bGH) or human IGF-I (hIGF-I) to normal rats or to rats that had undergone unilateral nephrectomy and two-thirds infarction of the contralateral kidney, and measured inulin and p-aminohippurate clearances over 10-17 days. Administration of either bGH (100-200 micrograms/day) or hIGF-I (200 micrograms/day) to rats with normal renal mass increased inulin and p-aminohippurate clearances compared with those measured in animals that received vehicle. Filtration fractions were not affected by either bGH or hIGF-I. Inulin clearance was decreased to approximately 17% of normal 1 day after reduction of renal mass in rats. Over the next 3 days insulin clearance increased significantly in rats with reduced renal mass that were administered vehicle. No further enhancement occurred during the next 7 days. Neither bGH nor hIGF-I affected inulin clearance in rats with reduced renal mass. We conclude that both GH and IGF-I enhance glomerular filtration rate when administered to rats with normal renal mass, but not when administered in the same quantities to rats in which renal functional mass is reduced. Glomerular filtration rate increases within 4 days of renal mass reduction independent of exogenous GH or IGF-I.

scholarly journals Giant jejunal gasto-intestinal stromal tumor: A rare cause of abdominal mass in an elderly female

2021 ◽  
Vol 1 (2) ◽  
pp. 65-67
Author(s):  
AC Diallo ◽  
A Ndong ◽  
I Niang ◽  
MB Ba ◽  
JA Thiam ◽  
...  
Keyword(s):  
Abdominal Mass ◽  
Pelvic Mass ◽  
Final Diagnosis ◽  
Progressive Increase ◽  
Stromal Tumor ◽  
Biological Assessment ◽  
Pathological Examination ◽  
Tissue Mass ◽  
Surgical Specimen ◽  
One Year

OBJECTIVE: We report the case of a patient presenting an abdominal mass whose final diagnosis is a gastrointestinal stromal tumor (GIST). CLINICAL OBSERVATION: It was a 61-year-old patient with no pathological history received for a progressive increase in the volume of the abdomen evolving for one year and painless. On examination, the patient was in good general condition, with normal patterns. There was an abdomino-pelvic mass of about 20 cm long axis, mobile. The rest of the exam was unremarkable. The biological assessment was normal. Abdominopelvic computed tomography revealed a tissue mass with necrosis. During the surgical exploration, a mass developed on the mesenteric border 45 cm from the Treitz angle was noted. It is not associated with ascites or peritoneal carcinoma. Bowel resection removing the mass was performed followed by end-to-end anastomosis. Pathological examination of the surgical specimen diagnosed GIST. The postoperative course at three months was excellent both clinically and radiologically. CONCLUSION: The case that we report underlines the possible jejunal localization of GIST and the clinical presentation may be usual. It also shows the difficulty of obtaining a preoperative diagnosis and the central role of surgery in management.

scholarly journals Adaptive functional change of the contralateral kidney after partial nephrectomy

2017 ◽  
Vol 313 (2) ◽  
pp. F192-F198 ◽  
Author(s):  
Se Young Choi ◽  
Sangjun Yoo ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Functional Change ◽  
Functional Changes ◽  
Contralateral Kidney ◽  
Before And After ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group 1

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min−1·1.73 m−2, group 2: 30–45 ml·min−1·1.73 m−2, and group 3: ≥45 ml·min−1·1.73 m−2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were −18.9, −3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: −0.105, 95% confidence interval (CI): −0.213; −0.011, P < 0.05] and preoperative contralateral GFR (β: −0.256, 95% CI: −0.332; −0.050, P < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

Renin content and excretory function of the kidney in rats with experimental hypertension

1962 ◽  
Vol 202 (4) ◽  
pp. 795-799 ◽  
Author(s):  
H. Brunner ◽  
P. A. Desaulles ◽  
D. Regoli ◽  
F. Gross
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Hypertension ◽  
Experimental Hypertension ◽  
Elevated Blood ◽  
Hypertensive Rats ◽  
Excretory Function ◽  
Contralateral Kidney ◽  
Ligation Of The Ureter ◽  
Renin Content

To determine relationship between kidney renin content and excretory function, rats with renal hypertension induced by unilateral clamping of the renal artery were given an oral load of 3 ml of 0.9% saline/100 g body wt. Excretion of the saline load was accelerated in rats with renal hypertension as well as in animals with hypertension due to overdosage with cortexone and salt, provided that the loading experiment was made 3–4 weeks after hypertension was established, but not when animals had been hypertensive for 11–14 weeks. Renin concentration was markedly reduced in the unclamped kidney and also in the kidney of the rats overdosed with cortexone and salt. Excreting capacity of the clamped kidney was compared with that of the unclamped kidney, after removal or after functional elimination of the contralateral kidney, by ligation of the ureter, 3, 24, and 48 hr after the operation. In all experiments excretion of saline load by the unclamped kidney was more rapid than by the clamped kidney, but the highest values were reached in the presence of a functional clamped kidney. Only in rats with elevated blood pressure was the load more rapidly excreted than in normal rats, but hypertension alone cannot be the only factor responsible, the excretion not being accelerated in unilaterally nephrectomized hypertensive rats. Although these hint at a connection between the renin concentration and renal function the nature of this relationship remains uncertain.

scholarly journals Obstructive uropathy associated with primary ureteral endometrioma: case report and review of the literature

2013 ◽  
Vol 3 (3) ◽  
pp. 10
Author(s):  
Andrew Feifer ◽  
Mona Alam El-Din ◽  
Atilla Omeroglu ◽  
Maurice Anidjar
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Postmenopausal Woman ◽  
Obstructive Uropathy ◽  
Flank Pain ◽  
Review Of The Literature ◽  
Gastrointestinal Complaint ◽  
Distal Ureter ◽  
Contralateral Kidney ◽  
Contrast Enhanced

We report the case of a 56-year-old postmenopausal woman whopresented with incidental left hydronephrosis during an investigationfor a gastrointestinal complaint. The patient denied any historyof flank pain or hematuria. Contrast-enhanced computedtomography revealed severe right-sided ureterohydronephrosis aswell as renal atrophy. The contralateral kidney was normal, as wasthe patient’s overall renal function. A retrograde ureterogramdemonstrated complete ureteral obstruction 4 cm proximal to theureterovesical junction. Subsequent ureteroscopy revealed a polypoidmass completely occupying the ureteral lumen, of which thebiopsies demonstrated inconclusive atypical urothelial changes.The patient underwent a laparoscopic nephrectomy with opendissection of the distal ureter. The patient recovered well postoperatively.Final pathology revealed a benign obstructingendometrioma without evidence of invasion from periureteraltissue. This appears to be the first reported case of asymptomaticprimary ureteral endometrioma with secondary renal atrophy.Earlier investigation and treatment may have allowed for renalpreservation earlier in the course of the disease.Nous décrivons le cas d’une femme ménopausée de 56 ans présentantune hydronéphrose gauche découverte de façon fortuite aucours d’un examen mené pour donner suite à des symptômes gastro-intestinaux. La patiente n’avait pas d’antécédents de douleurau flanc ou d’hématurie. Une TDM avec agent de contraste arévélé une urétéro-hydronéphrose droite importante accompagnéed’une atrophie rénale. Le rein controlatéral et la fonction rénaleglobale de la patiente ne présentaient aucune anomalie. Uneurétérographie par voie rétrograde a permis d’observer une obstructioncomplète de l’uretère proximale à 4 cm de la jonction urétérovésicale.Une urétéroscopie subséquente a révélé une masse polypoïdeoccupant la totalité de la lumière urétérale et des analysesaprès biopsie ont montré des changements atypiques non concluantsau niveau de l’épithélium urinaire. La patiente a subi unenéphrectomie par laparoscopie avec dissection ouverte de l’uretèredistale. La patiente s’est bien rétablie après l’intervention. Lerapport final de pathologie a révélé un endométriome obstructifbénin sans signe d’invasion des tissus péri-urétéraux. Il sembleque ce soit ici le premier cas signalé d’endométriome urétéralprimitif asymptomatique avec atrophie rénale secondaire. Un examenet un traitement réalisés plus tôt dans le cours de l’évolutionde la maladie auraient pu permettre la préservation du rein.

scholarly journals Comparison of the Effects of Mesenchymal Stem Cells with Their Extracellular Vesicles on the Treatment of Kidney Damage Induced by Chronic Renal Artery Stenosis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Crysthiane Saveriano Rubiao Andre Ishiy ◽  
Milene Subtil Ormanji ◽  
Edgar Maquigussa ◽  
Rosemara Silva Ribeiro ◽  
Antonio da Silva Novaes ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Chronic Hypoxia ◽  
Progressive Increase ◽  
Artery Stenosis ◽  
Irreversible Damage ◽  
Whole Cells

Background. Chronic renal artery stenosis is considered one of the most common causes of renovascular hypertension (RH). Chronic hypoxia can lead to irreversible damage to renal tissue and to a progressive deterioration of renal function. We have previously shown that bone marrow-derived mesenchymal stem cells (BMSCs) improved renal parenchyma and function in a model of RH (2 kidneys, 1 clip model (2K-1C) in rats. Microvesicles (MVs) and exosomes (EXs) released by MSCs have been shown to induce effects similar to those induced by whole cells but with fewer side effects. In this study, we compared the effects of adipose-derived MSCs (ASCs) with those of the MVs and EXs released by ASCs on tissue inflammation and renal function in 2 K-1C rats. Results. Flow cytometry analysis showed that even after 15 days, ASCs were still detected in both kidneys. The expression of a stem cell homing marker (SDF1-α) was increased in ASC-treated animals in both the stenotic and contralateral kidneys. Interestingly, SDF1-α expression was also increased in MV- and EX-treated animals. A hypoxia marker (HIF1-α) was upregulated in the stenotic kidney, and treatments with ASCs, MVs, and EXs were effective in reducing the expression of this marker. Stenotic animals showed a progressive increase in systolic blood pressure (SBP), while animals treated with ASCs, MVs, and EXs showed a stabilization of SBP, and this stabilization was similar among the different treatments. Stenotic animals developed significant proteinuria, which was reduced by ASCs and MVs but not by EXs. The increased expression of Col I and TGFβ in both kidneys was reduced by all the treatments, and these treatments also effectively increased the expression of the anti-inflammatory cytokine IL-10 in both kidneys; however, only ASCs were able to reduce the overexpression of the proinflammatory cytokine IL-1β in both kidneys of 2K-1C animals. Conclusion. The results of this study demonstrated that the EVs released by ASCs produced beneficial results but with lower efficacy than whole cells. ASCs produced stronger effects in this model of renal chronic hypoxia, and the use of EVs instead of whole cells should be evaluated depending on the parameter to be corrected.

scholarly journals Clusterin production in the obstructed rabbit kidney: correlations with loss of renal function.

1992 ◽  
Vol 3 (5) ◽  
pp. 1163-1171
Author(s):  
P N Schlegel ◽  
G J Matthews ◽  
Z Cichon ◽  
W K Aulitzky ◽  
C Y Cheng ◽  
...  
Keyword(s):  
Gene Expression ◽  
Renal Function ◽  
Ureteral Obstruction ◽  
Rabbit Kidney ◽  
Sodium Reabsorption ◽  
Mrna Levels ◽  
Mrna Accumulation ◽  
Contralateral Kidney ◽  
Collecting Ducts ◽  
Clusterin Protein

Clusterin, a protein associated with cell death, has been suggested as a marker of renal injury. Correlation of clusterin gene expression with changes in renal function and quantitative measurement of clusterin protein levels after ureteral obstruction have not been previously reported. With unilateral ureteral obstruction in rabbits as the experimental model, the time course of alterations in renal function, clusterin mRNA accumulation, and concentrations of clusterin protein in serum, urine, and renal tissue were investigated. RBF, GFR, and renal concentrating ability (percent sodium reabsorption and urine osmolarity) all decreased (P < 0.05) in the obstructed kidney from control values within 1 day of ureteral obstruction. Clusterin mRNA levels started to rise in the ipsilateral kidney within 12 h of ureteral obstruction and increased up to 10-fold above control levels after 3 days of obstruction. Hybridization histochemistry showed that clusterin mRNA was initially detectable in collecting ducts and distal tubules within 12 h of ureteral obstruction. After 7 days of obstruction, increased accumulation of clusterin mRNA was also detectable in proximal tubular epithelial cells. Clusterin gene expression remained elevated in collecting ducts after 60 days of obstruction. Clusterin expression in the contralateral kidney was increased twofold over control values after 12 h of obstruction. No increase in clusterin mRNA accumulation was detectable after 24 h in the contralateral kidney. Total clusterin protein in the obstructed kidney increased from 0.59 +/- 0.66 (mean +/- 1 SD) to 2.5 +/- 1.3 micrograms after 7 days of ureteral obstruction (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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