The Kidney in Congenital Ureteropelvic Junction Obstruction: A Spectrum From Normal to Nephrectomy

Seymour Rosen, Craig A Peters, Robert L. Chevalier, Weei Yuan Huang

Research output: Contribution to journalReview article

31 Citations (Scopus)

Abstract

Purpose: Our recent studies of renal histology in congenital ureteropelvic obstruction cases prompted us to review the literature in this regard, focusing on issues of development, normal variation, clinicopathological correlations and pathogenesis. Materials and Methods: The period from 1971 to 2006 was analyzed, including all relevant articles, which were critically reviewed. Results: There have been many studies encompassing the entity of ureteropelvic junction obstruction that include clinical findings, radiographic imaging, pathological examination of ureteropelvic junction obstruction per se and renal biopsies during pyeloplasty procedures. We synthesized this information in a cohesive review with a proposed classification. Conclusions: Congenital ureteropelvic junction obstruction is a spectrum that ranges from the radiological demonstration of apparent physiological ureteropelvic junction obstruction to a disordered ureteropelvic junction, characterized by smooth muscle hypertrophy and fibrosis associated with renal parenchymal changes that may necessitate pyeloplasty or nephrectomy. However, renal biopsies in patients in whom pyeloplasty is done show in most of them relatively well maintained parenchyma, in which overt changes are mainly glomerular. More subtle alterations have been described that relate to shifts in proximal-to-distal tubular ratios. Extreme thinning of the renal parenchyma can occur with only limited tubulointerstitial injury. Recently ureteropelvic junction obstruction was described in a series of genetically altered animals and placed in a more global context, ie CAKUT (congenital abnormalities of the kidney and urinary tract).

Original languageEnglish (US)
Pages (from-to)1257-1263
Number of pages7
JournalJournal of Urology
Volume179
Issue number4
DOIs
StatePublished - Apr 1 2008

Fingerprint

Nephrectomy
Kidney
Biopsy
Urinary Tract
Hypertrophy
Smooth Muscle
Histology
Fibrosis
Wounds and Injuries

Keywords

  • kidney
  • kidney pelvis
  • ureter
  • ureteral obstruction

ASJC Scopus subject areas

  • Urology

Cite this

The Kidney in Congenital Ureteropelvic Junction Obstruction : A Spectrum From Normal to Nephrectomy. / Rosen, Seymour; Peters, Craig A; Chevalier, Robert L.; Huang, Weei Yuan.

In: Journal of Urology, Vol. 179, No. 4, 01.04.2008, p. 1257-1263.

Research output: Contribution to journalReview article

Rosen, Seymour ; Peters, Craig A ; Chevalier, Robert L. ; Huang, Weei Yuan. / The Kidney in Congenital Ureteropelvic Junction Obstruction : A Spectrum From Normal to Nephrectomy. In: Journal of Urology. 2008 ; Vol. 179, No. 4. pp. 1257-1263.
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