[The morphology of reflux nephropathy and some forms of obstructive nephropathy]

There were investigated 42 nephrectomy and heminephrectomy specimens with proved vesicoureteral reflux and 113 specimens of various forms of obstructive nephropathy (17 cases of primary obstructive megaureter, 50 cases of pyeloureteral junction stenosis and 12 tumorous, 16 iatrogenic and 18 stone obstructions of the ureter). Macroscopic and microscopic findings and the distribution of immunohistologically determined Tamm-Horsfall protein were estimated. The comparison revealed that despite of some differences there are in some case many similarities on the histological level caused by common sharing of main pathogenetic and etiologic factors i.e. intrarenal reflux and/or urinary tract infection. The most difficult differential diagnostic problems may arise mainly in the group of primary obstructive megaureter and in some patients with the stenosis of pyeloureteral junction. In dubious cases macroscopic picture and clinical data have to be thoroughly evaluated.