renal hypoplasia
Introduction
Introduction to renal hypoplasia Renal hypoplasia refers to a kidney volume less than normal 50%, but the development and differentiation of the nephron is normal, and the ureter is normal. Renal dysplasia can be unilateral or bilateral, and the unilateral contralateral kidney is often compensated for hypertrophy. True renal dysplasia is a congenital disease, which is characterized by small kidney volume but normal renal parenchyma. Segmental renal dysplasia, also known as Ask-Upmark kidney, is characterized by small kidney volume and one or several deep grooves on the surface of the kidney. Its renal parenchyma is thyroid-like, and reflux is its possible cause. basic knowledge The proportion of illness: 0.0005%--0.0007% Susceptible people: no special people Mode of infection: non-infectious Complications: hypertension, ureteral ectopic opening
Cause
Causes of renal hypoplasia
(1) Causes of the disease
The disease is due to insufficient blood supply to the kidney during embryonic period or other reasons, causing some of the post-renal embryo base to lose normal development, and only a part of the nephron that develops into normal function, the collection system is reduced, and the ureter and renal blood vessels are small but not obstructed.
(two) pathogenesis
The shape of the kidney is naive, with embryonic lobes, less than half of the normal kidney, weighing 30-100g, short and thick renal pelvis, reduced number, narrow renal pelvis, poor renal excretion, most normal or compensatory contralateral kidney Hypertrophy.
Prevention
Kidney hypoplasia prevention
The key health care for renal hypoplasia is to prevent the kidney from developing on the healthy side. It can be checked regularly in the hospital. In women, although the kidney compensation function is good, the kidney burden is increased during pregnancy and perinatal period. And the health of the mother is a threat, it should be carried out under the supervision of the doctor, in addition, the general treatment of the disease, should pay attention to the use of drugs with high nephrotoxicity to avoid damage to the normal compensated kidney, and finally lead to uremia.
Complication
Renal dysplasia complications Complications, hypertension, ureteral ectopic opening
Often complicated by hypertension and other symptoms, in a few cases, dysplastic kidneys can be combined with ureteral ectopic opening, ureteral bulging, urethral obstruction and pear-shaped abdominal syndrome.
Symptom
Symptoms of renal hypoplasia Common symptoms Lymphatic or lower back pain Chronic renal insufficiency Hypertension Isolated kidney
Unilateral renal dysplasia, no clinical symptoms, when there are complications, such as high blood pressure, infection, stones, etc., often can show the corresponding clinical manifestations, about half of children with this disease have pain or high blood pressure in the affected side However, it was discovered that it was found to be a kidney-derived test. Due to the variation of the renal artery, the hypertensive disorder of the patient often responded poorly to antihypertensive drugs, and it developed rapidly. Visual impairment may occur within 1 to 2 years, and even Blindness, this disease can also be bilateral, but the size of the kidneys on both sides can be different, such children often have renal insufficiency, and may be associated with dwarfism and snoring, blood pressure abnormalities can be found during physical examination. Sometimes the contralateral side of the kidney can be compensated for.
The diagnosis of renal hypoplasia is mainly based on imaging findings. In patients with suspected renal dysplasia, B-ultrasound should be performed first, if necessary, intravenous pyelography or retrograde pyelography, the kidneys become smaller, close to the spine, and the shape is not regular; Contrast agent excretion is slow, development is not satisfactory, or not developed; renal pelvis dysplasia or narrow, triangular or ampulla; small number of renal sputum, varying degrees of deformation, angiography can not only understand the kidney status, but also can be detailed Observe changes in renal blood vessels.
Examine
Examination of renal hypoplasia
1. Renal hypertension can be detected due to renal artery variability. Angiotensin value is beyond normal. Bilateral renal dysplasia can detect creatinine and abnormal urea nitrogen.
2. B-ultrasound: It can be found that one or both kidneys are significantly smaller than normal. Radioactive kidney examination shows that one or both kidneys are impaired and excretion is delayed.
3. KUB IVU examination: visible side or bilateral renal shadow is significantly reduced, poor renal development, CT examination can be found that the kidney volume is significantly reduced.
4. Renal artery angiography: The renal artery is small, and the renal vascular network is narrow and sparse.
Diagnosis
Diagnostic identification of renal hypoplasia
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
1. Renal vascular hypertension: also persistent hypertension, but high blood systolic vascular murmurs can be heard in the upper abdomen or around the umbilicus. IVU shows that the kidneys are only slightly reduced, and the collecting system is normal. Renal angiography can be displayed. Renal artery stenosis and dilation after stenosis.
2. Chronic pyelonephritis: can be expressed as hypertension and renal shrinkage, but patients have a history of long-term urinary tract infection, urine routine examination can be seen white blood cells and cast, CT and MRI examination showed a reduction in renal volume, uneven surface, renal pelvis and renal pelvis deformation And expansion.
