Document Detail


Causal link between neonatal hydronephrosis and later development of hypertension.
MedLine Citation:
PMID:  19671072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
1. Although congenital ureteral obstruction is a common disorder in infants, its pathophysiology remains poorly understood and its clinical management continues to be debated. During the past decade, the surgical management of non-symptomatic hydronephrosis in children has become more conservative, but the long-term physiological consequences of this new policy are unclear. 2. In experimental models with complete ureteral obstruction, tubular atrophy and interstitial inflammation occur rapidly. Although this type of obstruction is very rare in clinical practice, it is often referred to in clinical discussions. New studies, using a model with chronic partial ureteral obstruction, have demonstrated that hydronephrosis is associated with renal injuries and is causally related to hypertension. 3. The mechanisms underlying the development of hypertension in experimental hydronephrosis are complex and involve changes in both the renin-angiotensin system and renal sympathetic nerve activity. Furthermore, oxidative stress and nitric oxide deficiency in the diseased kidney, with consequent resetting of the tubuloglomerular feedback mechanism, appear to play a pivotal role in the development and maintenance of hyper-tension. 4. In view of the new knowledge regarding the long-term effects of partial ureteral obstruction, today's non-operative management of hydronephrosis should be reconsidered to prevent obstructive nephropathy and hypertension in later life.
Authors:
Mattias Carlstr?m
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-08-04
Journal Detail:
Title:  Clinical and experimental pharmacology & physiology     Volume:  37     ISSN:  1440-1681     ISO Abbreviation:  Clin. Exp. Pharmacol. Physiol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-24     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0425076     Medline TA:  Clin Exp Pharmacol Physiol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  e14-23     Citation Subset:  IM    
Affiliation:
Department of Medical Cell Biology, Division of Integrative Physiology, Uppsala University, Uppsala, Sweden. Mattias.Carlstrom@mcb.uu.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Child
Humans
Hydronephrosis / complications*,  physiopathology,  surgery
Hypertension / etiology*
Infant
Infant, Newborn
Kidney / blood supply,  injuries,  innervation
Male
Mice
Nephritis / pathology
Nitric Oxide / deficiency
Oxidative Stress / physiology
Rats
Renin-Angiotensin System / physiology
Sympathetic Nervous System / physiopathology
Time
Ureteral Obstruction / complications*,  surgery
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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