Rapid loss of renal parenchyma after acute obstruction |
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Authors: | P Parvex J L Pippi-Salle P R Goodyer |
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Institution: | (1) Division of Pediatric Nephrology, Montreal Children’s Hospital, McGill University Health Center, Montreal, Quebec, Canada. Paul.Goodyer@muhc.mcgill.ca, CA;(2) Division of Pediatric Urology, Montreal Children’s Hospital, McGill University Health Center, Montreal, Quebec, Canada, CA |
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Abstract: | Urinary tract obstruction (UTO) is a frequent cause of renal failure in the pediatric population. We report a patient with
type I/I cystinuria, followed prospectively from birth with yearly ultrasonography, who developed acute UTO due to a cystine
stone at 10 years of age. In animal models of UTO, acute obstruction produces rapid loss of renal parenchyma secondary to
apoptosis of tubular cells. Since we had prospectively obtained serial ultrasonographic measurements of renal growth, we were
able to document sudden decrease in kidney size and function following UTO, suggesting that programmed cell death may similarly
have caused the rapid irreversible loss of renal parenchyma in our patient. Despite surgical relief of the obstruction, kidney
size decreased for at least 3–4 months. We speculate that anti-apoptotic drugs might be considered as a therapeutic strategy
to protect ongoing renal parenchyma loss in UTO.
Received: 26 April 2001 / Revised: 28 June 2001 / Accepted: 29 June 2001 |
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Keywords: | Urinary tract obstruction Cystinuria Apoptosis |
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