KIDNEY URETER CONGENITAL Anomalies

CONGENITAL ANOMALIES OF KIDNEY

These are :

a. Unilateral agenesis (absence of kidney on one side)Fig. 25.4

b. Supernumery kidney (more than two)

c. This is a rare occurrence and the renal tissue lies below  the

   normal  kidney  it is of no importance.  Ectopic  (present  in

   pelvis) Fig. 25.5

d. Crossed ectopic both on one side Fig. 25.6

e. Nephroptosis (mobile kidney)

f. Horse-shoe kidney (kidneys joined at one pole Fig. 25.7)

g. Cystic disease (solitary or multiple cysts)

An anomalous kidney can present with urinary infection since  the

drainage  system  may not be adequately develped, they  may  also

present with haematuria as a consequence.

Some of the conditions that need to be discussed further for they

present clinical problem are :

Unilateral  agenesis  occurs 1 in 1200 births  and  is  important

since the patient has only one functioning kidney. On no account,

can  nephrectomy be undertaken. Sometimes, the other  functioning

kidney can show hypertrophy and become palpable or there may also

be a mild ache.

Nephrotptosis   (mobile  kidney)  can  sometimes   present   with

intermittent  obstruction  giving rise to  repeated  pain,  lump,

fever  and  vomiting  (Deitl's Crisis),  the  lump  and  symptoms

disappear equally rapidly accompanied with polyuria.

Polycystic  disease  of the kidney can present later on  in  life

adult  with  unilateral or bilateral renal masses  and  signs  of

renal  failure. They can also present with Haematuria,  infection

and calculus disease.

The  cause  of  polycystic  disease is not known  but  may  be  a

developmental anomaly due to a n autosomal dominant gene probably

continuity between the nephron and the collecting tubules is  not

established.  The cyst on enlarging enterferes with the  function

of  the  adjoining  functioning nephrons. It is  the  third  most

common cause of renal failure.

Treatment  is non-surgical and is aimed at reducing  the  protein

load  in  the diet and control of infection. Patient  in  failure

require dialysis and transplant of kidney.

Any questions be sent to drmmkapur@gmail.com
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