EXPERIMENTAL STUDY OF HYDRONEPHROSIS
Urinary Components and Functional Recovery of Hydronephrosis
1985 Volume 76 Issue 4 Pages 575-587
Details
1985 Volume 76 Issue 4 Pages 575-587
In many clinical cases of hydronephrosis, obstructive nephropathy, a problem for which conservative treatment or nephrectomy should be undertaken, arise, because functional recovery cannot be predicted in the hydronephrotic condition. In order to clarify the conditions necessary for such recovery, the author performed the following experiment.
Methods: In 50 female mongrel dogs with hydronephrosis induced experimentally by completely ligating the unilateral ureter, changes in urinary components and various parameters of the renal function in the hydronephrotic condition during the period of the obstruction of the ureter were observed. After reopening the ureter, the contralateral ureter was ligated to determine the period of obstruction within which the hydronephrotic kidney could recover functionally to a level permitting maintenance of life with a single kidney. thus, the conditions necessary for functional recovery in the hydronephrotic condition were studied.
Results: 1) Osmotic pressure of hydronephrotic urine, UUN, Cr, and K at dehydration decreased along with the course of the obstruction. The ratio of hydronephrotic urine flow to contralateral kidney's urine flow, free water clearance and osmolar clearance also decreased with the course of occlusion.
2) Significant differences in the urine components and various parameters of the renal function at reopening were determined betwen the groups with and without functional recovery. There were significant differences (p<0.01) in the osmotic pressure of hydronephrotic urine and concentration of K at dehydration, free water clearance and the ratio of hydronephrotic urine flow to contralateral kidney's urine flow between the two groups. In the hydronephrotic condition with more than 320mOsm/l, 16mEg/l, 0.07ml/min and 0.2 of the above parameters, respectively, the function seems to recover to a level allowing maintenance of life even with a single kidney.
3) The function could recover to such a level within five weeks after obstruction.
4) NAG activity of the hydronephrotic kidney was higher than that of the normal kidney, but it was not a parameter showing recoverability.
