Thus, because during routine clinical practice one cannot directly examine a kidney, agenesis and aplasia cannot be distinguished in an individual unless the results of previous imaging are available that show the involution of a (previously visible) dysplastic kidney.
This process, which is associated with marked apoptotic death of dysplastic cells, can result in a tiny “aplastic” kidney which has no excretory function and which is below the limit of detection on ultrasound scanning. Dysplastic kidneys sometimes spontaneously involute, either antenatally or in the first few years after birth. As recently reviewed, the term “RTM” covers three main types of kidney malformation: (1) agenesis, where the embryonic kidney fails to initiate (2) dysplasia, where the kidney contains immature and metaplastic components, and may be cystic and (3) hypoplasia, where the kidney contains fewer glomeruli/nephrons than normal, with oligomeganephronia being a hypoplasia subtype with grossly enlarged nephrons. RTMs also contribute to adult ESRF populations where they may be under- or mis-diagnosed, for example appearing in categories such as “tubulo-interstitial disease” and “unknown”. Children with renal tract malformations (RTMs) constitute a large part of the clinical practice of pediatric nephrologists and RTMs also account for about 40% of children with end-stage renal failure (ESRF).
0 kommentar(er)
