Über pyelonephritische Schrumpfniere und hypogenetische Nephritis

Fahr, Th.

doi:10.1007/bf02595075

Cited by 40 publications

(5 citation statements)

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“…The clinical and histologic difficulties of distinguishing renal dysplasia from atrophic pyelonephritis have been discussed by many writers (Fahr, 1938;Abeshouse, 1941;Heritage, 1943; Residual nephrectomy performed in 1 case.…”

Section: Late Resultsmentioning

confidence: 98%

Conservative Renal Surgery in Pyelonephritis: A Follow-up Study

Myrvold

Fritjofsson

1972

Scandinavian Journal of Urology and Nephrology

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Thirteen patients with localized pyelonephritis in an otherwise apparently normal kidney and 22 patients with atrophic pyelonephritis, and sometimes also dysplasia, in one segment of a duplex kidney underwent partial nephrectomy. The indication for operation in both groups was recurrent urinary infection with or without refractory hypertension.Twenty-nine of the patients were followed up 5 to 21 years after the operation. Recurrent urinary infection was present postoperatively in 10 of the 12 re-examined patients who had had focal inflammation in an otherwise normal kidney and in 8 of the 17 with duplex kidney. No favourable effect of surgery on hypertension was demonstrated.In recurrent urinary infection and localized pyelonephritis, partial nephrectomy is indicated if the operation can also eradicate a cause of the infection. Renal hypertension per se does not constitute an indication for partial nephrectomy in adult patients.Partial nephrectomy has become a relatively common operation for renal lithiasis, tuberculosis, hydrocalycosis, trauma, tumours of a solitary kidney, etc. Localized chronic pyelonephritis has also been suggested as an indication for partial nephrectomy (Christoffersen, 1957;Poutasse, 1962;Semb, 1964). The rationale then was to clear the kidney, improve the prospects for effective chemotherapy and, in some cases, to reduce refractory intractable hypertension.We have followed up a series of patients who underwent partial nephrectomy for pyelonephritis. The long-term results of the operation were judged with regard to urinatry-tract infection and/or hypertension. 1 Present address: Urological Clinic, Regionsjukhuset, tirebro, Sweden. Scand J Urol Nephrol6 MATERIAL AND METHODSDuring the period 1947-1962, partial nephrectomy was performed on 13 patients at Sahlgrenska Sjukhuset's Surgical Clinic I in order to eradicate an apparently well demarcated focus of pyelonephritis in an otherwise healthy kidney. All of the patients were women. The upper renal pole was extirpated in 10 cases and the lower pole in 3. Minor resection which could be described as biopsies were not included in the series. The resected tissue was histologically examined in 11 of the 13 cases, and in all of them showed chronic pyelonephritis.In the same period 22 patients (17 of them women) with duplex kidney and atrophic pyelonephritis in one of the renal segments underwent 23 heminephrectomies. The upper part of a kidney was excised in 18 operations and the lower part in five. Histologic study was made of 21 resected specimens. In all of them a picture of chronic pyelonephritis was found and in ten specimens there were also changes coexistent with renal dysplasia.The indication for operation in both groups of patients was recurrent urinary infection, sometimes associated with refractory hypertension. Roentgenograms showed well-defined foci of pyelonephritis. In no case were calculi present at the primary operation.The age distribution of the patients is illustrated in Fig. 1.Twenty-nine of the 35 patients were followed up 5 t...

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Section: Late Resultsmentioning

confidence: 98%

Conservative Renal Surgery in Pyelonephritis: A Follow-up Study

Myrvold

Fritjofsson

1972

Scandinavian Journal of Urology and Nephrology

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“…Occasional reports of foci of renal dysplasia in kidneys with segmental 'atro phy' [20,44] suggest that sometimes the lesion may have developed in utero. There are, however, pathologic, clin ical and experimental data which indicate that it also could be postnatally acquired: first, one of the reasons to consider this entity as a malformation was the complete absence of glomeruli and inflammatory cells in the affected areas [21,41], However, Habib et al [22] dem onstrated the presence of glomerular remnants stained with PAS as small fibrohyaline masses in the classical 'aglomerular' segments. On the other hand, it seems that considerable clearing of inflammatory infiltrates can oc cur with time when the infection is eradicated [7,45,46] .…”

Section: Discussionmentioning

confidence: 99%

“…Urinary infection is very common in dysplastic kidneys, due to the associa tion with urinary tract malformations, like VUR [18], IRR has also been observed in dysplastic kidneys [40]. An element of acquired infective scarring may thus be superimposed in the dysplastic areas [7], Segmental atrophy was considered initially as a con genital disease [21,[41][42][43], clearly different from chronic pyelonephritis [22,23]. Occasional reports of foci of renal dysplasia in kidneys with segmental 'atro phy' [20,44] suggest that sometimes the lesion may have developed in utero.…”

Section: Discussionmentioning

confidence: 99%

Reflux Nephropathy: A Clinico-Pathological Study of 16 Cases

Gil-Salom¹,

Sánchez

Chuan³

et al. 1991

Urol Int

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The pathologic features of 16 nephrectomy specimens obtained from patients with a radiological diagnosis of reflux nephropathy were analyzed. Chronic pyelonephritis was diagnosed in 7 cases, renal dysplasia in 5 and segmental atrophy in 4. Clear correlations between pathologic pictures and pathogenic mechanisms involved in the development of renal lesions in kidneys with reflux are difficult to establish. These results show, however, that ‘reflux nephropathy’ is a broad term, which encompasses both congenital and acquired renal lesions.

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“…Before the PAS stain was available the glomerular remnants were not even recognized as such in some reports, and an 'aglomerular' dysplasia was described [13]. The noninflammatory nature of the basic glomerular change prompted Fahr [14] to invent many years ago the delightful term 'hypogenetische Nephritis' (pity he did not use 'nephropathy') to describe cases later designated as 'segmental hypoplasia' by Habib et al [8], The fact that an impressive majority of cases reported so far are in females adds a substantial argument in favor of considering this condition as a special form of dysgene sis, rather than an acquired change.…”

Section: Discussionmentioning

confidence: 99%