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Urology  (Expert Forum)
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Looking for info on hydronephrosis
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Looking for info on hydronephrosis

by Sandy, Aug 15, 1999 12:00AM
My 9 year old son, Jay, while hospitalized for another CVA in June of 1998, was found to have a nonfunctioning left kidney, due to UPJ obstruction. The CVA's were due to a left vertebral artery dissection. Which caused distal basilar artery occlusion with cerbellar and thalamic infarcts. The grossly enlarged kidney was noticed on a chest CT. After 6 months on Coumadin, he had a left nehprectomy. (Dec. 98)

His urologist has told us that the hydronephrosis was most likely congenital.



My question is it possible for this to be acquired? The reason I question this is because I had 4 ultrasounds while I was pregnant with him. And was told that he was developing normally. (The US were for bleeding due to a low lying placenta that caused some bleeding.) Also, of note. Jay had Hemolytic Uremic Syndrome in 1993, due to an E.coli infection.



The pathology report on the kidney stated, focal ureteral stricture with associated hydronephrosis, cystic cortical atrophy and chronic pyleonephritis.



Thank you for any information you may be able to give us.    Sandy

by hfhs M.D.-AK, Sep 02, 1999 12:00AM
Dear Sandy,

More than likely your son's condition was one that he was born with.  I presume the nephrectony was done because of the history of infection and a poorly functioning kidney on a renal scan.  If a kidney is showing cystic cortical atrophy at this early age, this process has been a chronic condition.  This further suggests that the hydronephrosis was congenital.  Also, the fact that you had negative ultrasounds does not eliminate the possibility that this condition was probably present during his fetal development.  A kidney must function in order to make urine in the collecting system sufficient to be seen on ultrasound.  What I'm saying is that an ultrasound can be negative in the face of a true UPJ obstruction.

Urine production is known to begin around 10 to 12 weeks of development.  It can be monitored in-utero by complicated ultrasound protocols in certain circumstances.  Usually, a child passes urine in the first 24 hours of life and no further tests are performed if the creatinine (measure of kidney function) is normal.

I believe your son's condition was congenital and his kidney was removed to prevent further problems to his health.  I wish you well and of coarse your son Jay.  

Member Comments (1)

by Antonio Guedes, Aug 29, 1999 12:00AM
To: Pediatric Urology
0

by labelle12, Mar 02, 2008 10:14PM
A related discussion, hydroneuphrosis was started.
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