Small kidney associated with primary vesicoureteral reflux in children. A pathological overhaul

In this series two quite distinct pathological entities accounted for the small, often deformed, kidney found over a severe primary ureterovesical reflux. One of them is due to dysplastic abnormal metanephric differentiation, and the other is a segmental tubular atrophy with glomerular metamorphosis. In our material there is no evidence to support an inflammatory pathogenesis in these conditions. An abnormal excess vascularization is explained by an arteriovenous fistula present in both. Proper identification of the pathology underlying such cases will assist further studies on the natural history of these two diverse malformations.