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Disorders of the Kidneys. IN: Tanagho, E.; McAninch, J., eds. Smith’s General Urology. 17th ed. Columbus, OH: McGraw Hill. 2008. pp 506-520.
This chapter about disorders of the kidneys is from an updated edition of a comprehensive textbook about urology that offers an overview of the diagnosis and treatment of diseases and disorders common to the genitourinary tract. The author begins with a consideration of congenital anomalies of the kidneys, including agenesis, hypoplasia, supernumerary kidneys, dysplasia and multicystic kidney, adult polycystic kidney disease (PKD), simple or solitary cyst, renal fusion, and ectopic kidney. For most conditions, the author reviews the etiology and pathogenesis, the pathology, clinical findings, differential diagnosis, complications, treatment, and prognosis. The chapter goes on to describe acquired lesions of the kidneys, including aneurysm of the renal artery, renal infarcts, thrombosis of the renal vein, arteriovenous fistula, arteriovenous aneurysm, renoalimentary fistula, and renobronchial fistula. The chapter is illustrated with numerous black-and-white drawings and photographs. The chapter concludes with an extensive list of references, categorized by topic. 9 figures. 34 references. 17 ..MJ.- Kidney Diseases. Congenital Anomalies. Acquired Disorders. Diagnosis. Symptoms. Etiology. Therapy. Patient Care Management.
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Disorders of the Ureter and Ureteropelvic Junction. IN: Tanagho, E.; McAninch, J., eds. Smith’s General Urology. 17th ed. Columbus, OH: McGraw Hill. 2008. pp 559-573.
This chapter about disorders of the ureter and ureteropelvic junction (UPJ) is from an updated edition of a comprehensive textbook about urology that offers an overview of the diagnosis and treatment of diseases and disorders common to the genitourinary tract. The author notes that congenital ureteral malformations are common and range from complete absence to duplication of the ureter. Specific anomalies discussed include ureteral agenesis, ureter duplication, obstructed megaureter, upper urinary tract dilatation without obstruction, acquired diseases of the ureter, retroperitoneal fibrosis, and ureteral obstruction secondary to malignant disease. Specific types of retroperitoneal fibrosis include retroperitoneal fasciitis, chronic retroperitoneal fibroplasias, and Ormond disease. The chapter is illustrated with numerous black-and-white drawings and photographs. The chapter concludes with an extensive list of references, categorized by topic. 12 figures. 100 references.
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Solitary Kidney. Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse. 2007. 4 p.
Most people have two kidneys, one on each side of the spinal column in the back, just below the rib cage. Kidneys perform many functions, including removing wastes and extra water from the blood, regulating blood pressure, balancing chemicals like sodium and potassium, and making hormones that keep the blood and bones healthy. This fact sheet reviews solitary kidney, a condition which may occur for one of three main reasons: renal agenesis, which is when a person is born with only one kidney; one kidney is removed to treat cancer or other diseases or injuries; or the donation of a kidney to be transplanted into a family member or friend whose kidneys have failed. Most people can live a normal, healthy life with one kidney, but taking precautions is wise to protect the function of the remaining kidney. Written in a question-and-answer format, the fact sheet reviews the possible effects of solitary kidney, the need for monitoring blood pressure and kidney functioning, the importance of controlling blood pressure, the role of nutrition, and steps to avoid injury. The fact sheet includes a summary of research programs on solitary kidney. The fact sheet concludes with the contact information for the National Kidney Foundation at www.kidney.org or 1–800–622–9010, the American Association of Kidney Patients at www.aakp.org or 1–800–749–2257, Life Options Rehabilitation Resource Center at www.lifeoptions.org or 1–800–468–7777, and the American Kidney Fund at www.kidneyfund.org or 1–800–638–8299, as well as a brief description of the activities of the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 3 figures.
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Congenital Abnormalities of the Kidney and Urinary Tract. IN: Hogg, R., ed. Kidney Disorders in Children and Adolescents: A Global Perspective of Clinical Practice. New York, NY: Informa Healthcare USA. 2006. pp 35-52.
This chapter about congenital abnormalities of the kidney and urinary tract is from a textbook that presents a global perspective of clinical practice regarding kidney disorders in children and adolescents. The author stresses that congenital abnormalities of the urinary tract are an important cause of morbidity and, occasionally, mortality in children. Topics covered include development of the renal tract, antenatally detected urinary tract abnormalities (AUTAs), antenatal intervention, investigations, renal agenesis, renal fusion and ectopia, duplex systems, renal dysplasia and hypoplasia, multicystic dysplastic kidney, pelviureteric junction (PUJ) obstruction, vesicoureteric junction (VUJ) obstruction, vesicoureteral reflux (VUR), posterior urethral valves (PUV), neuropathic bladder, renal cystic disease, familial nephronophthisis and medullary cystic disease complex, autosomal dominant medullary cystic kidney disease, medullary sponge kidney, and tuberous sclerosis complex (TSC). The author concludes that the use of antenatal ultrasound has resulted in increasing numbers of asymptomatic infants being referred for postnatal investigations and has changed perceptions of the natural history of many conditions. Pediatricians and nephrologists will have an increasing role to play in the ongoing monitoring process of children with these congenital conditions. The chapter includes black-and-white illustrations and photographs and concludes with an extensive list of references. 16 figures. 2 tables. 26 references.
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Pathology of the Infantile and Heterotopic Bladder. IN: Foster, C.S. and Ross, J.S., eds. Pathology of the Urinary Bladder. Philadelphia, PA: Saunders. 2004. pp. 67-74.
In functional terms, the adult urinary bladder is a rather simple organ of saccular shape that receives, stores, and expels urine. The development of the urinary bladder is, however, a very complex sequence of events, resulting from the interaction and differentiation of various structures during embryogenesis, including the urogenital sinus, cloacal membrane, Wolffian ducts, urachus, and urogenital mesenchyme. This chapter, from a textbook on urinary bladder pathology, considers the pathology of the infantile and heterotopic bladder. The chapter covers embryology of the urinary bladder; congenital anomalies, including agenesis and hypoplasia, persistent cloaca, and congenital division; and megacystis, including urachus and its anomalies, and defects of the cloacal membrane, the exstrophy-epispadiasis complex. The chapter includes full-color illustrations. 5 figures. 26 references.
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Kidney. In: MacLennan, G.T.; Resnick, M.I.; Bostwick, D.G.. Pathology for Urologists. New York, NY: Elsevier Science, Inc. 2003. p. 1-32.
This chapter on the kidney is from a pathology textbook that explores the full range of urology, including congenital, hereditary, inflammatory, degenerative, and benign and malignant neoplastic disorders found in the adrenal glands, kidney, renal pelvis, ureter, bladder, prostate, seminal vesicles, urethra, spermatic cord, testis, testicular adnexal, penis, and scrotum. The chapter includes full-color photographs of gross and microscopic pathologic specimens, representing virtually all of the common and rare entities seen in practice. Specific disorders covered are unilateral renal (kidney) agenesis, bilateral renal agenesis, hypoplasia, supernumerary kidney, simple ectopic kidney, crossed ectopic kidney, superior ectopic kidney, horseshoe kidney, hereditary cystic kidney diseases, acute pyelonephritis, chronic pyelonephritis, papillary necrosis, xanthogranulomatous pyelonephritis, malacoplakia, tuberculosis, renal adenoma, renal oncocytoma, metanephric adenoma, cystic nephroma, renal cell carcinoma (cancer), carcinoid tumor, small cell carcinoma, benign soft tissue neoplasms of kidney, renal sarcoma, lymphoma, tumors metastatic to the kidney, nephroblastoma (Wilms' tumor), cystic partially differentiated nephroblastoma, mesoblastic nephroma, clear cell sarcoma of kidney, and rhabdoid tumor of kidney. Each photograph is accompanied by a descriptive text section. The text also includes explanations of the most current neoplasm classification and staging systems. 82 figures. 1 table.
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A Solitary Kidney. Family Urology. 7(4): 14-16. 2002.
This article familiarizes family practice physicians with the condition of a solitary kidney (unilateral renal agenesis, URA). The authors stress that the outlook for patients who are born with one kidney is excellent. Overall longevity is not affected and URA does not predispose the contralateral (other side) kidney to greater than normal risk. The authors review the embryonic development of the kidneys, the prenatal diagnosis of URA, the late effects of URA (in middle age), sports participation recommendations for children with one kidney, dietary precautions, and the acquisition of a solitary kidney by loss of a kidney through disease or injury. The authors conclude that individuals born with solitary kidneys do not have an increased incidence of renal (kidney) dysfunction and most individuals never know that they have only one kidney. It is recommended that individuals with solitary functioning kidneys have long term followup with measurements of blood pressure, urine protein, and serum. 1 figure.
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Physical Examination. In: Corcos, J.; Schick, E., eds. Urinary Sphincter. New York, NY: Marcel Dekker, Inc. 2001. p. 251-260.
The urinary sphincter is the key to understanding both normal and abnormal function of the lower urinary tract. Its relationships with the bladder, the pelvic floor, and the bony structures of the pelvis are complex and incompletely understood. This chapter on the physical examination is from a textbook that presents a detailed and systematic account of the current knowledge on the anatomy, physiology, functional relationships, and range of dysfunctions that affect the urinary sphincter. The authors physical examination of the patient, together with a detailed clinical history, and whenever possible, the voiding diary, are the three cornerstones on which any further evaluation, diagnosis, and therapeutic plan are built. The components of the examination have not been universally agreed upon. The authors first describe the physical examination of children, including the findings of occult dysraphism (abnormality of the spinal column) and sacral agenesis (congenital absence of part or all of two or more vertebral bodies of the spinal column). The authors then describe the three steps for physical examination of the male patient, including the abdomen, the digital rectal examination (DRE), and neurological examination (which is virtually identical to that in the female). The physical examination of the female also focuses on three areas: the abdomen, the pelvic examination, and neurological examination. The neurological examination should include assessment of anal tone, its voluntary contraction, clinical evaluation of the bulbocavernous (or clitoridoanal) reflex, and evaluation of perineal sensation. 4 figures. 6 tables. 20 references.
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Focus On: Renal Disease in Alagille Syndrome. LiverLink. 7(4): 1, 3-8. October-December 2000.
Kidney (renal) disease is now recognized as a common feature of Alagille syndrome (AGS) and may be present in up to 40 percent of AGS patients. A variety of renal abnormalities that have a very wide spectrum of clinical significance (symptoms and complications) and severity have been described in AGS. This newsletter article reviews renal disease associated with AGS. AGS renal disease is a mixture of defects in the formation of the kidney, problems from lipid (fat) deposition in the kidney secondary to cholestasis (retention of bile contents in the blood stream), and vascular abnormalities. Each of these problems can lead to alteration in the normal filtration of the kidney. The article reviews the normal function of the kidney, which is to produce urine and keep the body's composition of electrolytes (sodium, potassium, bicarbonate) stable, and to filter proteins and waste products. The author describes defects in the formation of the kidney in AGS, including renal agenesis (absent kidney), duplications of the urinary tract, renal dysplasia (malformation), renal hypoplasia (small kidney with decreased ability to filter), and medullary cystic disease. Renal artery stenosis is a narrowing of the artery supplying the kidney that compromises the blood flow to the kidney. As a result of this stenosis, the kidney eventually shrinks and may lose some function. Many of these conditions lead to a functional renal condition called renal tubular acidosis (RTA); the author reviews this problem and stresses the importance of regular screening for and diagnosis of kidney problems in patients with AGS. 1 table.
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