Clinical and Molecular Markers of Chronic Interstitial Nephropathy in Congenital Unilateral Ureteropelvic Junction Obstruction

Murer, Luisa; Benetti, Elisa; Centi, Sonia; Vella, Manuela Della; Artifoni, Lina; Capizzi, Alfio; Zucchetta, Pietro; Prete, Dorella Del; Carasi, Carla; Montini, Giovanni; Rigamonti, Waifro; Zaccello, G.

doi:10.1016/j.juro.2006.08.055

Cited by 27 publications

(19 citation statements)

References 22 publications

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“…Operated kidneys with timely TTT had a mean THS of only 1.8 and the contralateral nonoperated kidneys only 1.2 (Table 1). Murer et al found a similar correlation between histologic changes and SKF and diuretic drainage pattern (26). TTT was not evaluated.…”

Section: Discussionmentioning

confidence: 94%

Diuretic Renography in Hydronephrosis: Delayed Tissue Tracer Transit Accompanies Both Functional Decline and Tissue Reorganization

Schlotmann¹,

Clorius²,

Rohrschneider³

et al. 2008

J Nucl Med

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The significance of delayed tissue tracer transit (TTT) of 99m Tcmercaptoacetyltriglycine ( 99m Tc-MAG3) has not been systematically evaluated in hydronephrosis. We sought to demonstrate that delayed TTT accompanies both functional decline and histomorphologic restructuring. Methods: Twenty 2-to 3-mo-old piglets with surgically induced partial unilateral ureteral stenosis were examined with magnetic resonance urography (MRU) to evaluate morphology and with 99m Tc-MAG3 diuretic renography (DR) to determine single-kidney function (SKF), evaluate the response to furosemide stimulation (RFS), and assess TTT. All animals had DR and MRU before and after surgery and a third DR after surgery. Piglets were sacrificed after the final DR for renal histology. A total histologic score (THS) was generated. Results: Preoperative DR demonstrated nonobstructive RFS, timely TTT, and balanced SKF in all 20 kidneys. After ureteral ligature, MRU demonstrated pelvic dilatation in all piglets. The postoperative DRs revealed 12 kidneys with delayed TTT in one or both followups. In these 12 kidneys, the SKF declined from 51% 6 4% to 18% 6 14%, and the THS was 9.0 6 4.0. Three kidneys always had timely TTT, balanced SKF, and a THS of 1.8 6 0.3. The contralateral, nonoperated kidneys had timely TTT and a THS of 1.2 6 0.9. Postoperative scintigrams showed that 3 of 8 kidneys (38%) with an obstructive RFS had timely TTT, which demonstrates that TTT and RFS are not equivalent. Conclusion: In hydronephrosis, a delayed TTT of 99m Tc-MAG3 accompanies both functional decline and histomorphologic restructuring in obstruction. According to the literature, a delayed TTT is determined by the filtration fraction of the kidneys and appears to identify an obstruction-mediated upregulated renin-angiotensin system.

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Section: Discussionmentioning

confidence: 94%

Diuretic Renography in Hydronephrosis: Delayed Tissue Tracer Transit Accompanies Both Functional Decline and Tissue Reorganization

Schlotmann¹,

Clorius²,

Rohrschneider³

et al. 2008

J Nucl Med

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“…In newborns, unilateral obstructed kidney was characterized by a poor outcome even when surgery was performed at an early stage, due to the fact that kidneys continued to develop tubular atrophy and interstitial fibrosis [58, 59]. The persistently low growth and volume of this unilateral obstructed kidney suggested a reduction in the total nephron number subsequent to apoptosis and/or inhibition of glomerulogenesis.…”

Section: Causes Underlying a Reduction In Nephron Numbermentioning

confidence: 99%

The Kidney from Prenatal to Adult Life: Perinatal Programming and Reduction of Number of Nephrons during Development

et al. 2009

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Modified embryonic-fetal development resulting in low birth weight may lead to a reduced nephron endowment, hypertension and renal diseases in adulthood. Regarding the involvement of genetic factors, several environmental conditions may also contribute towards reducing the number of nephrons in the fetus and infant, subsequently constituting a health burden in later life. To date no methods of investigation for the early detection of a reduced nephron reserve are available. However, more structured studies should be implemented to investigate the role of angiotensin-converting enzyme inhibitors in managing proteinurias and glomerulosclerosis in children with renal conditions characterized by reduce nephron number and glomerular hypertrophic changes. In view of the current lack of specific methods of investigation and management, close monitoring of children and young adults at risk of reduced renal reserve should be carried out to enhance the early detection of potential changes in renal function.

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“…Britton et al have suggested combined use of diuretic response and TTT parameters in the evaluation of obstruction [13]. Additionally Schlottmann and Murer et al have documented their findings with histologic changes in obstruction [4,14].…”

Section: Discussionmentioning

confidence: 99%

Surgical and Non-surgical Follow-up Results of Ureteropelvic Junction Obstruction

Zp¹,

Kara²,

Bakal³

et al. 2017

J Kidney

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Purpose: We aimed to retrospectively compare the surgical and nonsurgical follow-up results of ureteropelvic junction obstruction without diuretic response. Methods:Twenty nine pediatric patients (10 Female (F), 19 Male (M); mean: 4.4 ± 3.96 years old, range: 0-15) without diuretic response were subject of this study. The diuretic renography, intravenous pyelography, voiding and ultrasonography were performed within one month and were compared with control ultrasonography and/or diuretic renography results in 7.4 ± 6.7 month follow-up.Results: Among patients with surgical follow-up 11 (100%) had recovery. In the follow-up group which consist of 18 patients 7 patients (39%) had recovery, 5 had stable disease and 6 had additional pathologies (one ureter dilatation, infection in three, one worsening of diuretic response, one volume loss). Conclusion:In patients without diuretic response in scintigraphy even without conclusive morphological results, surgery is more appropriate approach.

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Clinical and Molecular Markers of Chronic Interstitial Nephropathy in Congenital Unilateral Ureteropelvic Junction Obstruction

Cited by 27 publications

References 22 publications

Diuretic Renography in Hydronephrosis: Delayed Tissue Tracer Transit Accompanies Both Functional Decline and Tissue Reorganization

Diuretic Renography in Hydronephrosis: Delayed Tissue Tracer Transit Accompanies Both Functional Decline and Tissue Reorganization

The Kidney from Prenatal to Adult Life: Perinatal Programming and Reduction of Number of Nephrons during Development

Surgical and Non-surgical Follow-up Results of Ureteropelvic Junction Obstruction

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