Hypoplasia of the kidney: symptoms and diagnosis

Hypoplasia of the kidney is one of the congenital anomalies of development, in which the organ has a normal structure, but is significantly reduced in size. A common case of hypoplasia is the lesion of one kidney, less often the pathology of both organs occurs. With hypoplasia, changes in the kidney tissue can be invisible, but can be expressed significantly. In the presence of gross deviations, the kidney loses its functions. If two kidneys are exposed to the disease, then a child with such a pathology can die from a developed kidney failure, because of which poisoning begins with metabolic products.
Hypoplasia of the kidney in the child exposes the body to the effects of infectious and inflammatory diseases, which violate its functions. In such a kidney, secondary pyelonephritis develops most often.

Hypoplasia of the kidney is diagnosed by radioisotope or ultrasound, and excretory urography. The use of renal arteriography makes it possible to clarify the size of the organ and to separate the developmental anomaly from diseases that cause a secondary decrease in the size of the kidney (nephrosclerosis).

Excretory urographs show a decrease in the size of the kidney. Its uneven contours and moderately dilated pelvis can make differential diagnosis more difficult. With hypoplasia, the calyx buds are not deformed, as in pyelonephritis, but only decrease in volume. With the help of renal angiography, you can see that with hypoplasia, the veins and arteries are thinned throughout the entire length, and with a wrinkled angiogram is similar to the picture of a burnt tree. The value of biopsy results in the disease is very limited.

Unilateral hypoplasia of the (right) kidney usually does not need treatment if the organ is not susceptible to the development of other pathologies (pyelonephritis complicated by arterial hypertension or wrinkling of the kidney). In difficult cases, adult patients are removed kidney (nephrectomy), children are trying to save the sick body, if it performs its functions at least a third. When the hypoplastic infected kidney is removed, the performance of its functions goes to the second healthy one. If both infected organs are removed, the kidney taken from the donor is transplanted .

In addition to the diagnosis of simple hypoplasia of the kidney, two more rare forms of this pathology are distinguished: rudimentary and dwarf dysplastic kidney. In the first case we are talking about a deviation, in which instead of the kidney there is only a sclerotic mass of a small size. In it, when histological examination is performed, the remains of the tubules and glomeruli are found. For a dwarf dysplastic kidney, in addition to a significant (up to 3-5 cm) reduction in size, the development of fibrous interstitial tissue and a sharp decrease in the number of glomeruli are characterized by excessive development. Sometimes the ureter can be obliterated.

Hypoplasia of the kidney: symptomatology

As already mentioned, unilateral kidney hypoplasia throughout life can not be manifested, however, it is noted that the anomaly is often affected by pyelonephritis and often causes nephrogenic hypertension. Bilateral hypoplasia manifests itself in infancy, children as a result of deviation lag behind in development and growth. They often experience diarrhea, vomiting, pallor, signs of rickets, the body temperature rises, in addition, the concentration function of the kidneys decreases. In this case, biochemical blood tests for a long time remain normal. Without violations, there is also arterial pressure, which rises only in the late chronic stages of renal failure.