Anomalies of the structure of the kidney parenchyma

Anomalies of the kidney parenchyma structure are divided into megacalix, spongy kidney, medullary cystic disease (Fanconi's disease).

[1], [2], [3], [4], [5], [6], [7], [8]

Forms

Megocalix (megakalikosis)

Megakalix (megakalikoz) - anomalies of the kidney parenchyma structure, congenital local non-retinal dilatation of the calyx. If all groups of calyxes are expanded, then this vice is called polymegacalix (megapolikalikoz). The pelvis and ureter have a normal structure. Bilateral lesion is typical for men, most common in the south-east Europeans. The causes of megakalikoza - hypoplasia of the Malpighian pyramids, as well as dysplasia of the muscles of the fornicks and calyx. Megakalikoz can be attributed to true cup-medullary anomalies. Because both causes (medullary and cup) are equal. With megacalcosis, there is no stagnation of urine in the calyx, which distinguishes it from retention hydrocalicoses. Megakalikoz diagnosed with ultrasound in the form of fluid formations in the brain substance of the kidney. However, differential diagnosis of megakalikoza with cysts and hydrocalicosis can be done with excretory urography. For megakalikoza full emptying of cups from the contrast medium on delayed images is typical (30-60 min). The same symptoms are found with MSCT. Uncomplicated megakalikosis does not require treatment. The most common complications of megalocosis are pyelonephritis and nephrolithiasis.

[9], [10], [11], [12]

Spongy kidney

Spongy kidney - anomalies of the kidney parenchyma structure, characterized by uneven (in the form of pseudocysts and diverticula) by the expansion of the majority of tubules of kidney pyramids. The renal glomeruli and the cup-and-pelvis system are developed normally. It occurs quite rarely - 0.32% among all renal anomalies, almost always in men, since this defect is hereditary, partially linked to the sex. Unilateral defeat is not typical, it happens in isolated cases. The most common complications of a spongy kidney are the following diseases: stone formation, pyelonephritis, hematuria, arterial hypertension.

Identify the spongy kidney can be after a survey of the organs of the urinary system, which You can see the accumulation of shadows of stones, shaped like pyramids. On excretory urograms, one can see sack-shaped dilations of the collecting tubules. These symptoms are more clearly defined by MSCT. Patients with stones located in the pelvis or migrating from it to the ureter are treated. To this end, endoscopic methods of removing stones, as well as DLT, are used.

Similar to a spongy kidney, embryo-fetal morphogenesis has a medullary cystic disease or Fanconi nephronophytosis. Despite similar structural changes, these are different types of malformations. Unlike the spongy kidney, medullary cystic disease is inherited by autosomal recessive (adolescent, nephronophytosis) and autosomal dominant (adult nephronophytosis, or actually medullary cystic disease) types. The defeat of the glomerular (hyalinosis) and tubular (atrophy of the epithelium) apparatus is expressed by the early occurrence of chronic renal failure due to the gradual shrinkage of the kidneys. According to some sources, it occurs in one of 100 000 observations.