ABSTRACT
Background: Kidneys are amongst the common sites of congenital abnormalities and anatomical variations.Congenital anomalies of kidney and urinary tract (CAKUT) constitute approximately 20 to 30% of all anomaliesidentified in the prenatal period and a leading cause of renal failure in children. The common variationspertaining to kidney are polycystic kidney, unascended kidney, horseshoe kidney with fused upper or lower pole,atrophic kidney, lobulated kidney, malrotated kidney, bifid pelvis or ureter, most common being bifid pelvis andpancake kidney is a very rare variant.Materials and Methods: Fifty human adult cadavers were included in our study; observed and studied over aperiod of three years in the Department of Anatomy, Grant Govt. Medical College, Mumbai, during routinedissection.Results: In our study we found, 01.01% of renal agenesis, 01.01% of fused pelvic or pancake kidney, 01.01% ofmalrotated kidney, 02.02% of unascended kidneys, 05.05% hypoplastic or atrophic kidneys, 07.07% lobulatedkidneys, 05.05% polycystic kidneys, 02.02% of bifid pelvis and 03.03% of triplicate pelvis.Embryological basis: The development of kidney begins at the fourth week of gestation; the failure of properinductive interaction between the ureteric bud and the metanephric blastemal can lead to various congenitalanomalies. Anomalies can result due to abnormal development, ascent, rotation and migration.Genetic basis: CAKUT are either sporadic, familial, syndromic or non-syndromic. Transcription factor ‘WT1’produced by mesenchyme of the metanephric blastemal helps in epithelialization of ureteric bud. Congenitalabnormality occurs when there is mutation of genes that regulates the expression of WT1.Conclusion: Renal anomalies are one of the commonest anomalies which may remain unnoticed till adulthood.The knowledge of anatomical variations of kidney and ureter is of utmost importance for surgical anduroradiological interventions. Hence an early detection and proper follow-up may be helpful in better managementand increased survival rates.
ABSTRACT
Anomalies of the urinary system constitute approximately 30% of all the congenital malformations. There are various associated anomalies involving number, size, shape, position and vascularity of the kidneys. Unascended kidneys refers to a halt in the migration of the kidneys during their normal embryological development. Defect in the ascent of the kidneys are closely related with variations in the branching pattern of aorta. Here we report a case of an unilateral unascended right kidney in a male cadaver encountered during routine medical dissection. A left sided ureteric calculi was also seen as an incidental finding in the same cadaver. Ureterolithiasis occurs worldwide in all sets of population with 80% of the stones found in the male sex in the age group of 30- 60 years. There are various factors which favour the formation of ureteric calculi which includes geographical, socio-economical as well as the mineral content of water consumed and some general medical causes. An attempt has been made to document the causes for this variation and the preventive measures that can be adopted to prevent the formation of ureteric calculi.