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Morphological Characteristics of Segmental Renal Scarring in Vesicoureteral Reflux

1992; Lippincott Williams & Wilkins; Volume: 148; Issue: 5 Part 2 Linguagem: Inglês

10.1016/s0022-5347(17)37011-8

1527-3792

Jay Bernstein, Billy S. Arant,

Ureteral procedures and complications

No AccessJournal of Urology1 Nov 1992Morphological Characteristics of Segmental Renal Scarring in Vesicoureteral Reflux Jay Bernstein, and Billy S. Arant Jay BernsteinJay Bernstein More articles by this author , and Billy S. ArantBilly S. Arant More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)37011-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We examined 25 complete and partial nephrectomy specimens from 21 patients with advanced reflux nephropathy, all of which showed severe renal atrophy and loss of parenchyma. All specimens that included nonatrophic or partially atrophic renal tissue contained small medullary scars that involved only portions of the medullary pyramids. These sublobar medullary scars, which appeared linear and were typically discrete, extended from the inner medulla to the cortex. They obliterated collecting ducts, vasa recta and recurrent loops. The cortical portions of the scars contained remnants of nephrons and variable infiltrates of chronic inflammatory cells with lymphoid follicles. Seven of the specimens also contained acute disruptive ductal lesions with histopathological features characteristic of intrarenal reflux. We believe that the linear scars are the result of single duct medullary disruptions, mediated perhaps through obstruction of the several thousand nephrons subtended by each papillary duct and perhaps through localized disruption of the renal microvasculature. These sublobar scars accumulate as scarring progresses to end stage renal atrophy. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByNGUYEN H, BAUER S, PETERS C, CONNOLLY L, GOBET R, BORER J, BARNEWOLT C, EPHRAIM P, TREVES S and RETIK A (2018) 99mTECHNETIUM DIMERCAPTO-SUCCINIC ACID RENAL SCINTIGRAPHY ABNORMALITIES IN INFANTS WITH STERILE HIGH GRADE VESICOURETERAL REFLUXJournal of Urology, VOL. 164, NO. 5, (1674-1679), Online publication date: 1-Nov-2000.Konda R, Sakai K, Ota S, Takeda A, Chida N, Sato H and Orikasa S (2018) SOLUBLE INTERLEUKIN-2 RECEPTOR IN CHILDREN WITH REFLUX NEPHROPATHYJournal of Urology, VOL. 159, NO. 2, (535-539), Online publication date: 1-Feb-1998.Guizar J, Kornhauser C, Malacara J, Sanchez G and Zamora J (2018) Renal Tubular Acidosis in Children with Vesicoureteral RefluxJournal of Urology, VOL. 156, NO. 1, (193-195), Online publication date: 1-Jul-1996.Allen T, Arant B and Roberts J (2018) Commentary: Vesicoureteral Reflux—1992Journal of Urology, VOL. 148, NO. 5 Part 2, (1758-1760), Online publication date: 1-Nov-1992. Volume 148Issue 5 Part 2November 1992Page: 1712-1714 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Jay Bernstein More articles by this author Billy S. Arant More articles by this author Expand All Advertisement PDF DownloadLoading ...