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Updates in: Obstructive Uropathy - Abstract

Ceri Elbourne, Rosa Romero



Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of renal failure in children. Obstructive uropathies represent an important part of this group. Obstruction to urinary flow may occur at any level of the urinary tract and may have adverse consequences on the developing fetus. Such consequences include renal dysplasia and the effects of oligohydramnios on lung and skeletal development. Causes of obstructive uropathy may be detected on antenatal screening allowing early identification and intervention in the post-natal period and, in some selected cases, antenatal intervention. Hydronephrosis is detected in up to 2% of pregnancies, many cases will be transient but others will signify congenital pathologies of the kidney and urinary tract. The challenge is therefore to identify those who will require intervention to protect their renal function and doing so at the correct time. Here we discuss important causes of congenital obstructive uropathy and review recent evidence and recommendations in this field. Vesicoureteric reflux is also discussed, as it is one of the commonest causes of paediatric renal problems, and is frequently diagnosed following an abnormal renal fetal scan.

Keywords: antenatal hydronephrosis, pelvi-ureteric junction obstruction, posterior urethral valves, megaureter, ureterocele, vesicoureteric reflux


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