[Renal duplication in childhood. Incidence and clinical significance (author's transl)]
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Insights
Renal duplication, a common urinary tract malformation, often presents with recurrent urinary tract infections in children. Diagnosis and management pose challenges for pediatricians, requiring consideration of associated anomalies.
Area of Science:
- Urology
- Pediatric Nephrology
- Congenital Malformations
Context:
- Renal duplication is the most frequent congenital anomaly of the urinary tract.
- It presents diagnostic and therapeutic challenges for pediatricians.
- Discovery often occurs incidentally or due to recurrent urinary tract infections (UTIs).
Purpose:
- To review the clinical presentation, diagnostic challenges, and management of renal duplication in children.
- To discuss the incidence, demographics, and associated anomalies of renal duplication.
- To highlight the link between renal duplication and other congenital malformations and diseases.
Summary:
- Urinary tract infections are the primary clinical manifestation in two-thirds of patients with renal duplication.
- Associated conditions include vesicoureteral reflux, ureterocele, hydronephrosis, and other urogenital malformations.
- Rarely, renal duplication is linked to tumors, tuberculosis, heart defects, or myelomeningocele.
Impact:
- Understanding renal duplication aids pediatricians in timely diagnosis and appropriate management.
- Identifying associated anomalies is crucial for comprehensive patient care and prognosis.
- This review provides insights into the systematic regularities and clinical significance of renal duplication.
Abstract:
Renal duplication is the most common malformation within the urinary tract system and as such a particular challenge to the pediatrician with regard to diagnosis and therapy. It is discovered either by chance or in relation to chronically recurring urinary tract infections. Urinary tract infection is the main clinical symptom in 2/3 of all the patients with renal duplication. Incidence, age-and sex-distribution, predilection of side or bilateral occurrence, configuration of the ureter and the statistically significant combination with vesico-uretral reflux show systematic regularities and are discussed in connection with the literature. Ureterocele, concrements, obstructions or hydronephrosis often are consequences of renal duplication or, as with hydronephrosis, correlated malformations like aplasia, hypoplasia, malrotation, horseshoe kidney or duplication of the urethra. There is a causative relation between renal duplication and tumors or tuberculosis. Other correlated malformations are particularly heart malformations or myelomeningocele. It depends on the severity of the disease whether therapy will be symptomatic or operative. Between 1968 and 1974 we saw 114 children with renal duplication.
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