Kidney hypoplasia is one of the congenital malformations in which the organ has a normal structure, but is significantly reduced in size. Common cases of hypoplasia are damage to one kidney, less often the pathology of both organs. With hypoplasia, changes in renal tissue may be invisible, but can be significantly expressed. In the presence of gross deviations, the kidney loses its functions. If two kidneys are affected, a child with such a pathology may die from the resulting renal failure, due to which poisoning of the body by metabolic products begins.
Kidney hypoplasia in a child exposes an organ to infectious and inflammatory diseases that interfere with its function. In such a kidney, secondary pyelonephritis most often develops.
Kidney hypoplasia is diagnosed using methods of radioisotope or ultrasound, as well as excretory urography. The use of renal arteriography makes it possible to clarify the size of the organ and to separate the developmental abnormality from diseases that cause a secondary decrease in kidney size (nephrosclerosis).
Excretory urograms show a decrease in kidney size. Its uneven contours and moderately dilated pelvis can complicate the differential diagnosis. With hypoplasia of the calyx, the kidneys do not deform, as with pyelonephritis, but only decrease in volume. With the help of renal angiography, it can be seen that with hypoplasia, the veins and arteries are thinned uniformly throughout, and with a wrinkled angiogram, it is similar to a picture of a burnt tree. The value of biopsy results for the disease is very limited.
Unilateral hypoplasia of the (right) kidney usually does not need treatment if the organ is not susceptible to the development of other pathologies (pyelonephritis, complicated by arterial hypertension or wrinkling of the kidney). In difficult cases, adult patients undergo kidney removal (nephrectomy), children are trying to save a diseased organ if it performs its functions by at least a third. When a hypoplastic infected kidney is removed, its functions are transferred to the second healthy one. If both infected organs are removed, a kidney transplant is taken from a donor.
In addition to the diagnosis of simple hypoplasia of the kidney, two more rare forms of this pathology are distinguished: a rudimentary and dwarf dysplastic kidney. In the first case, we are talking about a deviation in which, instead of a kidney, only a small sclerotic mass is present. In it, when performing a histological examination , the remains of tubules and glomeruli are found. For a dwarf dysplastic kidney, in addition to a significant (up to 3-5 cm) decrease in size, the development of fibrous interstitial tissue and a sharp decrease in the number of glomeruli are excessive. The ureter may sometimes be obliterated.
Hypoplasia of the kidney: symptoms
As already mentioned, unilateral kidney hypoplasia may not manifest itself throughout life, however, it has been observed that the anomaly is often affected by pyelonephritis and often causes nephrogenic hypertension. Bilateral hypoplasia manifests itself in infancy, children as a result of deviations lag behind in development and growth. They often have diarrhea, vomiting, pallor, signs of rickets, body temperature rises, in addition, the concentration function of the kidneys decreases. In this case, biochemical blood tests for a long time remain normal. Without disturbances, blood pressure remains, which increases only in the late chronic stages of renal failure.