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Embryology and Morphological (Mal)Development of UPJ
1Division of Pediatric Urology, Department of Pediatric Surgery, Ege University, Izmir, Turkey.
Frontiers in Pediatrics
|April 23, 2020
Summary
Congenital abnormalities of the kidney and urinary tract (CAKUT), like ureteropelvic junction obstruction (UPJO), have unclear causes. Research suggests multifactorial origins involving genetic and environmental factors.
Area of Science:
- Embryology
- Genetics
- Urology
Background:
- Congenital abnormalities of the kidney and urinary tract (CAKUT) arise from complex embryologic interactions.
- Ureteropelvic junction obstruction (UPJO) is the most frequent and studied CAKUT, yet its precise cause remains elusive.
- The pathogenesis of CAKUT is considered multifactorial, influenced by both genetic and environmental elements.
Purpose of the Study:
- To explore the etiopathogenesis of congenital abnormalities of the kidney and urinary tract (CAKUT).
- To investigate the underlying mechanisms contributing to ureteropelvic junction obstruction (UPJO).
Main Methods:
- Review of existing experimental and clinical research on kidney embryogenesis and CAKUT.
- Analysis of proposed mechanisms for UPJO, including developmental failures and genetic factors.
Main Results:
- Proposed mechanisms for UPJO include renal pelvis development failure, ureteropelvic junction recanalization issues, abnormal innervation, and impaired smooth muscle differentiation.
- Specific gene mutations (e.g., AGTR2, BMP4, Id2) are implicated in the etiopathogenesis of UPJO.
Conclusions:
- The exact etiopathogenesis of UPJO within the broader CAKUT spectrum is still under investigation.
- Understanding the interplay of genetic and environmental factors is crucial for elucidating UPJO development.
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