renal hypoplasia of the child - a decrease in body size, but the normal operation and histological structure.In the main, this pathology is one-sided, but occasionally affects both kidneys.
When hypoplasia in children resort to surgery only in case of failure of conventional therapy.Among the congenital malformations of the urogenital system such deviation is 8 - 11%.
hypoplasia is formed due to improper development of the kidney still in the embryonic period.In appearance and in function hypoplastic kidney looks like a normal body, only somewhat smaller.But there are some histological changes, making it possible to classify the pathology to simple hypoplasia or in combination with oligonefroniey and dysplasia.
For a simple hypoplasia is characterized by the presence of a smaller number of cups and kidney nephrons.Hypoplasia with oligonefroniey seen a decrease in the number of renal glomeruli in conjunction with an increase in their size, interstitial tissue fibrosis and en
hypoplasia right or left kidney in a child clinically may be asymptomatic, but often develops in the affected kidney pyelonephritis, provoking increasing the pressure inside the body.
Severe bilateral hypoplasia manifest themselves early - already in the first years of life of the newborn.At the same time children are lagging behind in physical development, they noted pale skin, frequent fever, diarrhea and signs of rickets.Also strongly deteriorating renal concentrating ability
Clinical symptoms of pathology
Unilateral hypoplasia of the left or right kidney can not occur throughout life, but often reduced kidney is affected pyelonephritis and becomes a source of formation of high blood pressure.
It reduced kidney can cause the development of hypertension in the early stages of the child's life.Such forms of hypertension may take malignant course, and the main method of treatment in such a situation becomes a nephrectomy, but only if a unilateral lesion.
Bilateral lesion body is formed very early - the snake in the early stages of life after the baby is born, that is, even in the first weeks of his life.At the same time, children with diseased kidneys begin to lag behind in their development and growth.Often they have been vomiting, paleness, diarrhea, increased body temperature, may present symptoms of rickets.
also seen a marked deterioration in the kidney function of concentration, but these biochemical examination even for a long time do not change and do not deviate from the norm.blood pressure is also normal, but only lifted on the condition of chronic disease development.Often, the disease can be complicated by a severe form of pyelonephritis.
main method of patient examination is ultrasound diagnosis.In addition to identifying the degree of organ functionality organized excretory urography and radioisotope examination.
kidney revealed the data of the survey, the size of which will be less than normal, the number of cups will be no more than six, and pelvis will have a modified structure.Simultaneously with these variations ureter normal size can remain the same or be decreased.Besides obstruction may occur, stenosis, the expansion in the ureters and renal artery remains undeveloped in any way.
reduced organ histological structure in the absence of other complications corresponds to their age norm.When a unilateral lesion can be diagnosed malformations in the development of the other kidney, such as its doubling, dysplasia or hydronephrosis.
renal hypoplasia in the newborn should be differentiated from secondary processes organ atrophy, for example, nephrosclerosis or contracted kidney, developing due to chronic inflammation, obstructive lesions - pyelonephritis, nephritis, renal artery stenosis, renal failure.
When hypoplasia cups are not subjected to strain, unlike pyelonephritis, but only reduced the number and size, and becomes visible urograms compensatory hypertrophy of the second kidney.
an important role in the differential diagnosis of the disease plays a holding kidney angiography.When hypoplasia lumen diameter veins and renal artery decreased by 1.5 - 2 times in comparison with vessels of healthy kidneys.Subsequent vascular generation also thinned, but can be traced up to the periphery of the kidney.At the secondary contracted kidney in the pictures traced the normal diameter of the renal artery, but the rest of generating significantly narrowed, bent, most of them are chopped off, and peripherals can not be traced at all.
diagnostic value of renal biopsy is extremely low.
If the fetus develops hypoplasia and further does not manifest itself after the birth of the child, the treatment may not be required, as condition for a long time is compensated second kidney.
necessity of treatment is shown in the development of secondary lesions, which explains the constant progressive changes in hemodynamics, urodynamics, infection of the urinary channel and the formation of nephrosclerosis.
In the absence of clear evidence of kidney failure, it is recommended to diet with low salt concentration and limiting consumption of animal proteins.It is important to follow the diet and life.Upon activation of negative processes required embolization of the arteries in the kidney, or nephrectomy - removal of the affected kidney.Treatment of renal hypoplasia of the child subject to the preservation of its work on 30% of the body suggests preservation.
In case of increase of symptoms of kidney failure, dialysis patients transferred to, and they recommended the organization of an organ transplant.
With the development of bilateral hypoplasia, complicated by a severe form of renal failure, the only option is to save the life of a bilateral nephrectomy, and conduct follow-kidney transplant.Only highly qualified specialist can make a decision about these or other actions with respect to the patient.