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[Renal function of contralateral kidney after total or partial removal of kidney with ectopic ureter]
Abstract:
The effects of partial or total removal of the kidney with ectopic ureter on the contralateral kidney were evaluated using DMSA renal uptake rate on 8 patients. After partial nephrectomy on 6 cases, the affected residual kidneys showed significant decrease in DMSA renal uptake rate in 2 cases in which the extirpated kidneys had normal renal tissue in part but did not show significant change in DMSA uptake rate in 4 cases in which the extirpated kidneys were dominated mainly with dysplasia. Post-operative increase in DMSA uptake rate of the contralateral kidneys were significant in 3 of 4 patients who had the operation before they became 2 years old. In 2 of these 3 cases, pre-operative scintigram showed extremely low rate of DMSA renal uptake. Four cases aged 2 years old and over did not show post-operative increase in the uptake rate. As we have previously reported on the cases with hydronephrosis, these results suggest that 1) existence of obstruction caused by ectopic ureter inhibit the development of the contralateral kidney and 2) the growth of the kidney can resume the release of that obstruction, if the release is made while the kidneys are still in developing stage.
Insights
Kidney removal due to ectopic ureters can impact the remaining kidney. Early surgery in children under two promotes contralateral kidney growth, suggesting timely intervention is crucial for kidney development.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Imaging
Context:
- Ectopic ureters can lead to kidney obstruction and affect contralateral kidney development.
- Assessing the impact of nephrectomy on contralateral kidney function is crucial for pediatric patients.
Purpose:
- To evaluate the effect of kidney removal (partial or total nephrectomy) for ectopic ureters on the contralateral kidney's function.
- To determine the optimal timing for surgical intervention to preserve or improve contralateral kidney function.
Summary:
- DMSA renal uptake rates were analyzed in 8 patients undergoing nephrectomy for ectopic ureters.
- Partial nephrectomy showed varied effects on residual kidney function, depending on the degree of dysplasia in the removed kidney.
- Contralateral kidney function significantly improved post-operatively in 3 out of 4 patients operated on before age two, especially those with pre-existing low uptake.
Impact:
- Early surgical release of obstruction caused by ectopic ureters, particularly before age two, can promote contralateral kidney development.
- Delayed intervention in older children may not result in compensatory contralateral kidney growth.
- Findings highlight the importance of timely intervention in managing ectopic ureters to optimize long-term renal outcomes.