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Status and development of the kidney after surgical treatment of hydronephrosis in children

, : Status and development of the kidney after surgical treatment of hydronephrosis in children. Urologiia: 39-43

Development of the kidneys after correction of hydronephrosis was studied in 40 patients operated at the age of 8 months-12 years. Follow-up lasted 10-25 years. X-ray control showed efficiency of correction of the uretheropelvic segment (UPS). Roentgenoplanimetric study demonstrated a uniform 50-100% increase in renal area and its parenchyma in 28 patients (32 kidneys). In 9 patients parenchyma increased 2.5-4-fold, renal area by 50-100%. In three cases parenchyma diminished by 3-10% in growth of the kidney by 24-80%. This evidenced of nephrosclerosis progress. UPS correction favoured renal growth and development. There were only few cases when correction of UPS was positive but nephrosclerosis aggravated. Development of the kidney may depend on many factors such as preoperative condition of the kidney, severity of UPS obstruction, the patient's age, duration and severity of pyelonephritis, dysplasia and age-related immaturity of renal parenchyma, immune status of the organism, microorganism virulence, etc. But decisive was the condition of renal parenchyma before the operation. In 3 patients with progressive nephrosclerosis renal parenchyma affection was additionally characterized by advanced sclerosis and inflammatory infiltration of the intertitium which ended in a poor outcome. The above observations suggest the necessity of long-term postoperative follow-up of the patients to design effective measures aimed at the treatment and prevention of nephrosclerosis.


PMID: 12357899

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