| Theme |
Congenital Kidney Disease and Renal Failure |
| Title |
Obstructive uropathy and renal failure |
| Author |
Kenji Shimada |
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health |
| Author |
Fumi Matsumoto |
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health |
| Author |
Futoshi Matsui |
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health |
| Author |
Takashi Obara |
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health |
| [ Summary ] |
Obstructions during nephrogenesis induce diverse interactions between ureteral buds and metanephric blastema, resulting in a decrease in the functioning nephrons and trans-differentiation into renal dysplasia. Severe forms of obstruction, mainly in the lower urinary tracts, may lead to renal insufficiency in neonates or young infants. Screening ultrasonography during prenatal and neonatal periods has altered the clinical manifestations, diagnostic methods, and selection of management modalities. Urinary drainage is prompted in children with renal dysfunction and electrolyte disturbances. Although fetal intervention for severe obstructive uropathy associated with oligohydramnios may be one treatment option, indication for use and efficacy have not been internationally recognized. |