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[The pediatric pelvic kidney--a retrospective analysis].
P F Engelhardt1, L Lusuardi, C R Riedl
1Department für Kinderurologie, Krankenhaus der Barmherzigen Schwestern, Linz, Austria. paul.engerhardt@thermenklinikum-baden.at
Aktuelle Urologie
|August 1, 2006
Summary
Pelvic ectopic kidneys in children often present with suspected renal agenesis and may have reduced function, but overall renal clearance remains normal. Follow-up shows stable function, with some needing surgical intervention for associated pathologies.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Imaging
Background:
- Pelvic kidney, a congenital anomaly where the kidney is located in the pelvic cavity, can be mistaken for renal agenesis.
- Understanding the function and associated pathologies of pelvic kidneys is crucial for accurate diagnosis and management in children.
Purpose of the Study:
- To evaluate children diagnosed with pelvic ectopic kidney.
- To assess initial renal function and the development of concomitant urological pathologies.
- To analyze follow-up data regarding renal function and the need for surgical intervention.
Main Methods:
- Retrospective analysis of 17 children (8 female, 9 male) with pelvic ectopic kidneys diagnosed between 1994 and 2002.
- Utilized nuclear medicine scans to assess renal function and ultrasonography for anatomical evaluation.
- Reviewed case notes for presenting symptoms, associated pathologies, and surgical interventions.
Main Results:
- 10/17 children were initially investigated for suspected renal agenesis.
- Nuclear scans showed reduced function of the ectopic kidney (one-third) compared to orthotopic kidneys (two-thirds), but overall global renal clearance was normal.
- 4/17 children (23.5%) required surgical correction for associated conditions like vesicoureteric reflux or ureteropelvic junction obstruction.
- Left-sided pelvic kidneys were more common (64.7%).
Conclusions:
- Pelvic ectopic kidney should be considered in cases of suspected renal agenesis on ultrasonography.
- Despite reduced individual kidney function, overall renal function in children with pelvic kidneys is typically normal and stable.
- A significant proportion of children with pelvic kidneys may present with or develop concomitant urological pathologies requiring management.