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Renal Hypoplasia and Dysplasia in Infants with Posterior Urethral Valves

1980; Lippincott Williams & Wilkins; Volume: 123; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)56190-x

1527-3792

Michael Henneberry, F. Douglas Stephens,

Congenital gastrointestinal and neural anomalies

No AccessJournal of UrologyPediatric Articles1 Jun 1980Renal Hypoplasia and Dysplasia in Infants with Posterior Urethral Valves Michael O. Henneberry and F. Douglas Stephens Michael O. HenneberryMichael O. Henneberry and F. Douglas StephensF. Douglas Stephens View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)56190-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The morphology of 22 kidneys and the urinary tracts in 12 children who died of severe but incomplete urethral obstruction owing to posterior urethral valves showed many variations in structure. The dilatation of the calices and the thinness of the parenchyma may be explained on the basis of atrophy from back pressure of obstruction and reflux but the etiology of variants, such as asymmetrical kidney morphologies, the occurrence of near normal renal parenchyma in some kidneys exhibiting all the ureteral and caliceal stigmas of severe obstruction and the high incidence of renal dysplasia, was not clear. The position of the ureteral orifices was known and available for this study, and the structure of the kidneys, using suitable methods of quantifying glomerular populations and dysplasia, was assessed for comparison and correlates. The renal morphology in these cases correlated with the position of the ureteral orifice, which in turn relates to the site of origin of the ureteral bud from the wolffian duct and the location of the corresponding segment of the nephrogenic cord induced by the bud. When this “bud theory” was invoked we noted that those features of renal morphology that could not be readily explained by back pressure effects were accounted for more readily by the “bud theory” of renal development. A near normally placed orifice signified a near normal renal structure in the newborn, whereas lateral and diverticular orifices were associated with hypoplasia and hypodysplasia of the kidneys, respectively. We concluded that incomplete urethral obstruction with or without reflux was not the primary cause of the structural anomalies of the kidneys, abnormal ureteral orifice positions denoted primary developmental malformations in the nephrogenic and stromagenic mesenchyme of the nephrogenic cord and partial urethral obstruction together with reflux did not impair the subsequent nephron development in the fetus to any marked extent. © 1980 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGreenfield S (2018) Editorial CommentJournal of Urology, VOL. 183, NO. 3, (1184-1184), Online publication date: 1-Mar-2010.BROCK J, HUNLEY T, ADAMS M and KON V (2018) ROLE OF THE RENIN-ANGIOTENSIN SYSTEM IN DISORDERS OF THE URINARY TRACTJournal of Urology, VOL. 160, NO. 5, (1812-1819), Online publication date: 1-Nov-1998.Denes E, Barthold J and Gonzalez R (2018) Early Prognostic Value of Serum Creatinine Levels in Children With Posterior Urethral ValvesJournal of Urology, VOL. 157, NO. 4, (1441-1443), Online publication date: 1-Apr-1997.Close C, Carr M, Burns M and Mitchell M (2018) Lower Urinary Tract Changes After Early Valve Ablation In Neonates and Infants: Is Early Diversion Warranted?Journal of Urology, VOL. 157, NO. 3, (984-988), Online publication date: 1-Mar-1997.Reinberg Y, Allen R, Vaughn M and McKenna P (2018) Nephrectomy Combined With Lower Abdominal Extraperitoneal Ureteral Bladder Augmentation in the Treatment of Children With the Vesicoureteral Reflux Dysplasia SyndromeJournal of Urology, VOL. 153, NO. 1, (177-179), Online publication date: 1-Jan-1995.Rittenberg M, Hulbert W, Snyder H and Duckett J (2018) Protective Factors in Posterior Urethral ValvesJournal of Urology, VOL. 140, NO. 5 Part 1, (993-996), Online publication date: 1-Nov-1988.Glassberg K, Stephens F, Lebowitz R, Braren V, Duckett J, Jacobs E, King L and Perlmutter A (2018) Renal Dysgenesis and Cystic Disease of the Kidney: A Report of the Committee on Terminology, Nomenclature and Classification, Section on Urology, American Academy of PediatricsJournal of Urology, VOL. 138, NO. 4 Part 2, (1085-1092), Online publication date: 1-Oct-1987.Greenfield S, Hensle T, Berdon W and Wigger H (2018) Unilateral Vesicoureteral Reflux and Unilateral Nonfunctioning Kidney Associated with Posterior Urethral Valves—A Syndrome?Journal of Urology, VOL. 130, NO. 4, (733-738), Online publication date: 1-Oct-1983.Livne P, Delaune J and Gonzales E (2018) Genetic Etiology of Posterior Urethral ValvesJournal of Urology, VOL. 130, NO. 4, (781-784), Online publication date: 1-Oct-1983.Kaplan G (2018) Editorial CommentJournal of Urology, VOL. 130, NO. 4, (784-784), Online publication date: 1-Oct-1983.Demos T, Malone A and Schuster G (2018) Unicaliceal Kidney Associated with Posterior Urethral ValvesJournal of Urology, VOL. 129, NO. 5, (1034-1035), Online publication date: 1-May-1983.Hoover D and Duckett J (2018) Posterior Urethral Valves, Unilateral Reflux and Renal Dysplasia: A SyndromeJournal of Urology, VOL. 128, NO. 5, (994-997), Online publication date: 1-Nov-1982. Volume 123Issue 6June 1980Page: 912-915 Advertisement Copyright & Permissions© 1980 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Michael O. Henneberry More articles by this author F. Douglas Stephens More articles by this author Expand All Advertisement PDF downloadLoading ...