Solitary kidney

Introduction On the embryonic side, the kidney tissue and the ureteral germ were not developed, and the contralateral side was an isolated kidney. Not uncommon. However, due to the absence of clinical symptoms, the incidence rate is difficult to count. One out of about 1,000 to 1,500 births is a single kidney. More men than women, more on the left than on the right. There is no ureter on the side without the kidney. Due to physiological needs, the contralateral kidney is often compensatory. If the shape and function of the kidney are normal, it is not treated clinically. It is usually unintentional to find a patient with a solitary kidney during an angiographic examination. Prenatal ultrasound can distinguish polycystic kidney or renal hypoplasia, thereby improving the detection rate of this disease.

Cause

There is no significant difference between URA embryo development and BRA. The main problem is in ureteral buds. On the one side of the embryonic stage, the growth of renal tissue and ureteral buds is disordered, and the contralateral kidney is often compensatory hypertrophy. The undeveloped kidney has no renal parenchyma, renal pelvis and renal pedicle remnant. The ureter is cord-like fibrous tissue without lumen.

an examination

Related inspection

Nephropathy, routine urine, plain radiography, urine routine renal function test

1. Cystoscopy: It can be seen that the trigone of the bladder is asymmetrical, one side of the ureteral fistula is flattened, and the ureteral orifice is absent. Some have a nozzle, but the intubation is blocked; the other side of the ureteral orifice is in the normal position, but also in the midline, posterior urethra or seminal vesicle.

2. Abdominal plain film + KUB venous urography (IVU): one side of the kidney shadow is absent, not developed, the contralateral renal shadow is enlarged, and other deformities of the isolated kidney can be found.

3. B ultrasound, CT, kidney map, renal angiography, etc. can assist in diagnosis.

Differential diagnosis

1. Renal hypoplasia: imaging examination showed that one side of the kidney shadow was significantly reduced, the renal pelvis and renal pelvis became smaller, but the shape was normal, the contralateral kidney was compensatory, both bilateral ureters were present, and the ureteral opening position was normal under cystoscopy. Patients may have high blood pressure.

2. Renal atrophy: imaging examination showed unilateral renal shadow or bilateral renal shadow reduction, renal pelvis and renal pelvis distortion, deformation, displacement; often primary causes such as pyelonephritis, renal contusion, renal arteriosclerosis, etc.; Bilateral lesions may have progressive renal insufficiency and often have high blood pressure.

3. Fusion kidney: Although there may be ectopic, intravenous urography and CT, MRI examination showed two kidney fusion images, and each has a ureter, cystoscopy ureteral opening position is normal.

4. Self-cutting kidney: The kidney loses function due to tuberculosis, and the cheese-like tissue is often accompanied by calcification. The imaging examination is easy to distinguish.

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