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[Ask-Upmark kidney: a case report]

K Takase1, Y Ogo, H Misaki

  • 1Department of Urology, Yokosuka Kyosai Hospital.

Hinyokika Kiyo. Acta Urologica Japonica
|June 1, 1994
PubMed
Summary
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This case study presents an 18-year-old male with Ask-Upmark kidney, hypertension, and hematuria. Surgical removal of the affected kidney normalized renin levels and reduced blood pressure, suggesting a congenital origin.

Area of Science:

  • Nephrology
  • Urology
  • Pediatric Nephrology

Background:

  • Ask-Upmark kidney, a rare congenital renal anomaly, is characterized by focal cortical thinning.
  • Its etiology is debated, with some suggesting a link to vesicoureteral reflux.

Observation:

  • An 18-year-old male presented with hypertension, microscopic hematuria, and proteinuria.
  • Hormonal studies showed elevated plasma renin activity (PRA).
  • Imaging revealed cortical thinning, calyceal dilatation, and a cortical groove without arterial stenosis.

Findings:

  • Significantly higher left renal vein PRA compared to the right.
  • Successful left simple nephrectomy led to normalized PRA and decreased blood pressure.
  • The absence of vesicoureteral reflux in this case challenges acquired etiology theories.

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Implications:

  • This case supports a congenital etiology for Ask-Upmark kidney, distinct from acquired causes like reflux.
  • Understanding the pathogenesis is crucial for accurate diagnosis and management of renal hypertension in young patients.
  • Further research into congenital renal anomalies and their hormonal impact is warranted.