Congenital Urinary Tract Obstruction: State of the Art Strategic Planning Workshop
Lister Hill Auditorium
National Institutes of Health
March 11-12, 2002
SummaryCongenital obstructive nephropathy remains one of the major causes of renal insufficiency and renal failure in infants and children. The pathogenesis of these disorders remains poorly understood, as most experimental studies of urinary tract obstruction have been performed in adult animals. In the few published studies of fetal and neonatal urinary tract obstruction, there are marked differences between the renal response to obstruction in these models compared to those in adults. It is clear that urinary tract obstruction interferes with normal growth and development of the kidney. In addition to the questions surrounding prevention and short-term intervention in affected fetuses or infants, there is the broader concern regarding the long-term outcome of these patients. A number of experimental and clinical studies have demonstrated that urinary tract obstruction during maturation can result in a decrease in the number of nephrons. This, along with the early tubulointerstitial changes caused by obstruction, may have implications for progression over decades, leading to hypertension or renal insufficiency in adulthood.
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