Experimental Obstructive Hydronephrosis in Newborn Rats. XI. A One-Year Follow-Up Study of Renal Function and Morphology.

Claesson, Gösta; Svensson, Leif; Robertson, Bengt; Josephson, Staffan; Cederlund, Torsten

doi:10.1016/s0022-5347(17)39177-2

Cited by 33 publications

(26 citation statements)

References 26 publications

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“…There was no con vincing evidence of any change with time. The hypertro phy was moderate, but comparable to what we observed with permanent obstruction: the contralateral weight was 9% above controls after 6 weeks [16], 6% after 9 weeks [17,18] and 13% after 1 year [ 19], Irreversibility is one explanation for persistence of con tralateral hypertrophy; its existence has, however, been debated. In normal rats with a normal, third transplant kidney, both absence [7,20] and presence [6,9] of reversal have been observed.…”

Section: Discussionsupporting

confidence: 84%

Experimental Partial Ureteric Obstruction in Newborn Rats

Josephson

Larsson²

1996

Urol Int

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In unilateral kidney disease, it has been suggested that the ipsilateral state could be estimated by measuring contralateral kidney size; thus, a contralateral increase should reflect an ipsilateral impairment and vice versa. This could easily be performed using ultrasound. In our experiments with partial obstruction of one ureter (created in 1- to 3-day-old rats), a consistent and stable contralateral kidney hypertrophy occurred. However, after unobstruction, the hypertrophy persisted for at least a 6-week observation period, despite the disappearance of hydronephrosis and presence of a normal weight of the ipsilateral kidney. This would undeniably hamper the diagnostic utility of kidney size determination. To find out whether or not the hypertrophy ever disappears, we have performed studies after 6, 9 and 15 weeks. (1) The weight of the unobstructed kidney was found normal except after 15 weeks. The microstruc-ture was normal except for some minor changes. (2) The contralateral kidney was significantly heavier than controls at all checkpoints (+10, +13 and +6%). No significant regression occurred over the observation period. (3) Furthermore, the weights of both kidneys were interrelated, but the slopes were positive, thus, the contralateral hypertrophy was not greater the lesser the ipsilateral kidney weight. The reasons for the persistence of contralateral hypertrophy are discussed. The present findings do not support the idea of documenting improvement by measuring contralateral kidney size. However, repeat studies in the same individual may prove to be more sensitive and are therefore recommended until further notice.

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Section: Discussionsupporting

confidence: 84%

Experimental Partial Ureteric Obstruction in Newborn Rats

Josephson

Larsson²

1996

Urol Int

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“…As these are retrospective studies, we cannot establish the relationship between the duration of ureteral obstruction and the degree of changes in parenchyma. It is well known that there is a linear relationship between the duration of the obstruction and loss of renal function Claesson et al, 1989;Ito et al, 2004). On the other hand, all the ureteral stones do not cause obstructions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Yildirim¹,

Açıkgöz²,

Danacı³

et al. 2012

jecm

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ÖZETUzun süren üreteral obstrüksiyonun böbrek fonksiyon kaybına neden olduğu iyi bilinmektedir. Üriner sistem taşına bağlı herhangi bir obstrüksiyonun kontrastsız çok kesitli bilgisayarlı tomografi (KÇKBT) ile belirlenmesi tedavi zamanlaması hakkında karar vermek açısından çok önemlidir. Çalişmamızda deneysel hidronefroz oluşturulan ratlarda renal parankim dansitesinde meydana gelen değişiklikler KÇKBT ile değerlendirildi. Bu çalışmada sol üreterlerinde total veya parsiyel obstrüksiyon oluşturulmuş SpraqueDawley ratların böbrek parankim dansiteleri deneyin 1.,3. ve 30. günlerinde KÇKBT ile değerlendirilerek, sham ve kontrol grubu ratların böbrek parankim dansiteleri ile karşılaştırıldı. Parsiyel üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansiteleri ile kontrol grubunun böbrek parankim dansiteleri arasında anlamlı bir fark olmadığı saptandı. Bununla birlikte total üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansitelerinin karşı taraf böbrekleri ve kontrol grubu ile karşılaştırıldığında anlamlı olarak azaldığı saptandı. Böbrek üst, orta ve alt segmentlerinin ortalama dansite değerleri benzerdi. Elde edilen bu bulguların insanlarda üreter obstrüksiyonun sonuçlarının değerlendirilmesinde yararlı olabileceğini düşünmekteyiz. KÇKBT değerlendirilmesinde renal parankim dansitesinin azalması renal parankimal hasarın bir göstergesi olabilir.J. Exp. Clin. Med., 2012; 29:215-220 It is well known that a prolonged ureteral obstruction leads to function loss of the congested kidney. Determining whether kidney stones cause any obstruction by noncontrast multislice CT is crucial for deciding about the timing of treatment. In our study we evaluated by Non-Contrast Multislice Computed Tomography (NCMSCT) detectable reliable changes of the density of the renal parenchyma in rats with artificial hydronephrosis. We made total or partial obstruction to left ureters of Spraque-Dawley rats, and applied sham operation to control groups. Using NCMSCT we measured the renal average parenchyma densities in the first, third and thirteenth days of operation. There was no significant difference between the parenchyma density of partial obstructed group and control group. However the parenchyma density in totally obsructed kidneys has significantly decreased compared to the contralateral kidneys and control group. In this group the duration of the obstruction correlated with signifıcantly decreased parenchyma density. The average density values of the upper, middle and lower renal segments were similar. We assume that our results can be useful in the evaluation of the consequences of the ureteral obstruction. The decrease of the parenchyma density evaluated in NCMSCT could be an important indicator of the renal parenchymal damages.

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“…Already on its maiden voyage downstream, the urine is confronted by the obstructed pyeloureteral junction, resulting in a high intrapelvic pressure that is reversed only when the pelvic dilation is established. Pelvic pressure peaks occur only rarely thereafter [14], and may as such explain the absence of progression during a year despite presence of an obstruction that is significant for the whole period [15]. Deterioration appears only if the obstruction becomes aggravated: temporarily by a sharpened 'high insertion' kink during diuresis [12], or chronically by postinfection fibrosis of the obstructed segment of the ureter.…”

Section: Discussionmentioning

confidence: 99%

Experimental Partial Ureteric Obstruction in Newborn Rats

Josephson

Jacobsson²,

Larsson

1998

Urol Int

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Partial obstruction of the left ureter was created in newborn rats. Unobstruction was performed after 2 or 7 days. The investigations were carried out at 9 weeks of age – under slight hydropenia to institute an element of stress. Unobstruction was successful. On the unobstructed side, there were nevertheless impairments as compared to controls: urine osmolality (–32%), free water reabsorption (–44%), potassium excretion (–34%), renal blood flow (–36%) and glomerular filtration (–36%). On the intact contralateral side, tubular changes were the only signs of an attempt to compensate. Thus, consistent renal damage remained despite a very early unobstruction. Furthermore, the changes were similar to those we observed during long-term permanent obstruction. The injury seems to be established within a very short time and imitates the probable development seen in the affected fetus: after start of production, the urine is confronted by the preformed obstruction at the pyeloureteral junction. A high-pressure-prone system is built up and is not reversed, until the pelvis has become dilated and thus capable to buffer urinary flow peaks. Thereafter, no further deterioration occurs except in specific conditions. If clinically applicable, these observations implicate that there is no advantage with surgical intervention, even when performed early in fetal life, and there is no need for swift intervention, as the damage does not progress after its establishment. Most of the cases probably do not require surgery at all, unless pain, obvious functional impairment or urinary tract infection supervene.

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Experimental Obstructive Hydronephrosis in Newborn Rats. XI. A One-Year Follow-Up Study of Renal Function and Morphology.

Cited by 33 publications

References 26 publications

Experimental Partial Ureteric Obstruction in Newborn Rats

Experimental Partial Ureteric Obstruction in Newborn Rats

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Experimental Partial Ureteric Obstruction in Newborn Rats

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