Diminutive kidney, hypoplasia or atrophic
pyelonephritis, may be the cause of
hypertension, lumbar or
abdominal pain, obscure gastrointestinal symptoms or chronic urinary
infection accompanied by
chills and
fever. A hypoplastic kidney is prone to
infection and stone formation.Diagnosis includes meticulous x-ray examination and renal function studies employing the more accurate quantitative
phenolsulfonphthalein test of each kidney.
Nephrectomy is the treatment for unilateral disease causing symptoms; localized atrophic
pyelonephritis is amenable to partial resection. Since urinary stasis invites
infection, obstructing ureteral
strictures should be dilated.
Pyelectasis, secondary to ptosis, and ureteropelvic obstruction should be corrected by nephropexy or
plastic repair. These conservative measures may prevent renal destruction.SIXTEEN PATIENTS WERE SUBJECTED TO
NEPHRECTOMY: Six because of persistent
pain and
chronic infection and ten because of
hypertension. The six with
pain and chronic urinary
infection were relieved. In six of the ten with
hypertension, the disease recurred within six months to seven years.