Renal Insufficiency in a Solitary Kidney Secondary to Hydronephrosis of Pregnancy

Abstract

A case is reported of renal insufficiency in a solitary kidney secondary to hydronephrosis of pregnancy. Evidence supporting obstruction on a mechanical basis is presented. This entity should be considered when pursuing a correctable cause for functional renal deterioration in pregnant women. The clinical importance of this entity in the management of renal insufficiency in the pregnant woman is discussed.

Acute Renal Failure due to Bilateral Ureteral Obstruction by the Pregnant Uterus

“…How ever, in vivo and in vitro studies have been carried out with contradicting results [4,5,7,8]. In favor of an obstructive cause of dilatation are the facts that: (1) only the upper ureter is found dilated sug gesting ureteral compression by the gravide uterus at the level of the pelvic brim [3]; (2) a preponderance of right sided hydronephrosis in approximately 85% of cases in accordance with the different course of the right and left ureter when they cross the iliac vessels [3,5,15], and, (3) studies measuring intraureteral tonus at different lev els of the ureter have shown a significant difference between pregnant and nonpregnant women [9,10].…”

Dilatation of the Urinary Tract during Pregnancy and Its Management

“…Furthermore there are cases in which this obstruction occurs acutely, resulting in renal colic [14], Even renal insufficiency can ensue under certain condi tions [13]. In some cases of extremely painful colic a dif ferential diagnosis of pregnancy dilatation and stone dis ease has to be made.…”