Pathophysiology of obstructive nephropathy

Summary Obstruction of the urinary tract is a common and often reversible cause of renal failure. Partial chronic obstruction of the urinary tract may lead to progressive atrophy and destruction of nephrons resulting in chronic renal failure; in contrast complete obstruction occurring suddenly may result in the development of acute renal failure. The mechanisms by which obstructive diseases affect renal function are incompletely understood. Much information has been obtained using animals models of obstruction, ranging from studies using whole animal to those using single nephrons. In this review, the effect of either unilateral or bilateral obstruction on renal blood flow, glomerular filtration rate and tubular function is presented. The possible involvement of angiotensin II, thromboxan A₂, macrophage-derived products and platelet-activating factor in the pathophysiology of obstruction is discussed.This work was supported by the Frank Strick Foundation and the Joseph Alexander Foundation.