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Renal tubular abnormalities in infants with hydronephrosis
J Chandar1, C Abitbol, G Zilleruelo
1Department of Pediatrics, University of Miami, Jackson Memorial Medical Center, Florida, USA.
The Journal of Urology
|February 1, 1996
Summary
Renal tubular dysfunction is common in infants with hydronephrosis, affecting 58% of those studied. This often presents as renal tubular acidosis, requiring medical investigation for proper management.
Area of Science:
- Pediatric Nephrology
- Urology
- Biochemistry
Background:
- Hydronephrosis can cause renal tubular dysfunction, leading to metabolic acidosis, hyperkalemia, and excessive free water diuresis.
- The prevalence of these abnormalities in infants necessitates further study.
Purpose of the Study:
- To determine the frequency of renal tubular function abnormalities in infants with hydronephrotic urinary tract disease.
- To characterize the types of tubular dysfunction observed.
Main Methods:
- A cohort of 50 infants with hydronephrosis, diagnosed via ultrasound, voiding cystourethrography, and radionuclide renal scan, was studied.
- Patients were classified by lesion laterality and severity.
- Tubular function was assessed through serum and urine electrolyte measurements.
Main Results:
- 58% of infants (29/50) exhibited at least one tubular function abnormality.
- Renal tubular acidosis was the predominant abnormality (46% of all patients), typically distal.
- Other findings included impaired urinary concentrating ability (20%) and distal tubular aldosterone resistance (12%).
Conclusions:
- Renal tubular dysfunction is frequent in infants with hydronephrosis, regardless of lesion laterality.
- While often self-limiting, the metabolic implications warrant investigation for appropriate medical management.