Functional Characteristics of Idiopathic Hydronephrosis

Suspected Pyelo-Ureteral Junction Obstruction in the Fetus: When to Do What? I. A Clinical Update

“…No other study reports such a high frequency (table IB), the highest being 56% [24], Concomitant investigation of pelvis drainage was performed in only four studies. The kidneys, thus found obstructed, were functionally depressed in only 47 % (the range in the different series was 30-80%) of a total of 15 antenatally detected obstructions [63,64], and in no more than 24% (range 21-70%) of totally 181 adult ones [57,60], The relative contribution of the functionally depressed kidneys was usually fairly good: 34% (range 30-39%) in neonates [24], 25% (range 0-40%) in chil dren [24,[79][80][81], and 23% (range 5-39%) in adults…”

“…Zetterström et al [86] observed a limited capacity to lower pH on acid load and concentrate urine in 2 children. In adults before operation, Bratt and Nils son [60] observed normal p2-microglobulin levels; how ever, maximum concentration ability was reduced, but only in those patients with previous urinary tract infec tions and calculi. Immediately after relief of the obstruc tion, Tm PAH and excretions of phosphate, sodium, osmoles, calcium, ammonium, hydrogen and titrable acid were decreased, but these changs were in proportion [82], However, a decrease in the differential values of the renogram should be interpreted very cautiously, since it does not relate to the normal but to the contralateral, nonobstructed moiety.…”

“…However, a functional disturbance should indicate a late stage of the obstructive nephropathy, especially with regard to RBF and GFR changes, which probably come after the tubular effects [60,61]. To me, ureteric obstruc tion implies an impeded urinary outflow from the region above the obstruction.…”

“…However, even then, it is difficult to draw any definitive conclusion, since the normal range is so wide. Furthermore, when actually measured, the re sults have been conflicting, either normal [24,60,84] or reduced [80], speaking in favor of and against a contra lateral increase.…”

Partial Ureteric Obstruction in Weanling Rats

“…The clinical literature lists only four studies of only a few parameters of tubular functions before release of the obstruction; they indicate a defective concentration capacity [4][5][6][7], The experimental studies are more de tailed but very contradictory. Thus, in adult animals, urine excretion was found increased [8][9][10] or decreased [11], sodium excretion increased [9,10] or decreased [8.…”