[Renal development long after correction of primary non-refluxing forms of megaureter in children]

We studied the condition and development of 50 kidneys in 45 patients 10-30 years after surgical correction of megaureter. We made resection and neoimplantation of the ureter according to the antireflux technique. By x-ray findings, we estimated area of the kidney, renocortical index and compared them with visual assessment of the condition of the kidney and its pelvicocalicyal system. We have found that correction of the megaureter creates favourable conditions for development of the kidney as shown by good growth of the kidney (area increased 1.5-3.5 fold) in a stable renocortical index. This indicates stabilization of nephrosclerosis and large area of renal parenchyma. However, kidney growth was accompanied with developing nephrosclerosis in 7 cases, in 1 case nephrosclerosis terminated with secondary contraction and a decline of renal function. The condition of the kidney varied due to many factors such as the condition of the immune system, age of the patient, virulence of the microflora, etc., but the key role for the kidney belonged to condition of renal parenchyma before surgical intervention. The data of light optic (53 cases) and electron-microscopies (3 cases) examinations of renal biopsies demonstrated that renal lesions were characterized by congenital structural disorders such as low number of nephrons, the presence of canalicular and glomerular microcysts and other manifestations of hypoplastic dysplasia. Inflammatory infiltration of the cortical and medullary layer interstitium aggravated severity of renal lesion. Various correlation and severity of congenital and aquired lesions characterized condition of the kidney in each individual case. Thus it is necessary to conduct a long-term follow-up and update methods of therapy.