Ureteropelvic junction obstruction causes histologic alterations in contralateral kidney

J Pediatr Surg. 2003 Nov;38(11):1650-5. doi: 10.1016/s0022-3468(03)00578-5.

Abstract

Background/purpose: Ureteropelvic junction (UPJ) obstruction causes histologic alterations both in ipsilateral and contralateral kidney. Because these alterations directly affect the fate of renal damage, definition of these alterations is of utmost importance from the clinical point of view. Thus, an experimental study is designed to determine the alterations of renal histology in response to partial and complete UPJ obstruction.

Methods: Fifteen adult female New Zealand rabbits were assigned randomly into 3 groups (each containing 5 rabbits) according to the degree of unilateral UPJ obstruction as group I, sham operation was performed and served as the control group; group II, partial UPJ obstruction was made; group III, complete UPJ obstruction was made. The animals in group I and II were killed after 3 weeks, and animals in group III were killed after 2 weeks. Tissue samples were prepared and processed according to routine light microscopic tissue processing.

Results: UPJ obstruction led to glomerulosclerosis, dilatation of proximal and distal tubules of loops of Henle, and dilatation of collecting tubes consistent with necrotic and apoptotic changes in ipsilateral kidneys. Severity of these degenerative changes depended on degree of obstruction. UPJ obstruction also led to histologic alterations on the contralateral kidneys such as glomerular edema, congested blood vessels, dilated tubuli, and necrotic and apoptotic changes in epithelia, which were more prominent in group III than group II.

Conclusions: It is well known that compensating changes including increased blood flow and parenchymal hypertrophy occurs in contralateral kidney as a response to unilateral UPJ obstruction. However histologic findings of this study confirmed progression of parenchymal damage and presence of apoptosis in contralateral kidney for the first time.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Apoptosis
  • Constriction, Pathologic / pathology
  • Female
  • Kidney / pathology*
  • Kidney Glomerulus / pathology
  • Kidney Pelvis / pathology*
  • Necrosis
  • Rabbits
  • Ureteral Obstruction / pathology*