Hipertensão renovascular levando à nefrectomia unilateral: relato de caso / Renovascular hypertension leading to unilateral nephrectomy: case report

Objetivo: Relatar o caso de uma paciente jovem portadora de Hipertensão Arterial Secundária à estenose da artéria renal, que evoluiu com perda renal em decorrência de necessidade de nefrectomia unilateral, enfatizado a importância do diagnóstico e da abordagem adequada desta patologia para o controle da pressão arterial e preservação da função renal. Método: Os dados foram obtidos através de entrevista com a paciente, análise de prontuário, laudos de técnicas diagnósticas, as quais a paciente foi submetida, entre julho e novembro de 2019, durante as consultas médicas e revisão bibliográfica. Conclusão: A nefrectomia unilateral mostrou-se eficaz no controle da hipertensão arterial, na melhora do desempenho renal, possibilitando a melhoria na qualidade de vida do indivíduo afetado

Objective: To report the case of a young patient with SAH secondary to renal artery stenosis, who developed renal loss due to the need for unilateral nephrectomy, emphasizing the importance of the diagnosis and the appropriate approach of this pathology for the control of blood pressure and preservation of renal function. Method: The data were obtained through interview with the patient, analysis of medical records, reports of diagnostic techniques, which the patient was submitted between July and November 2019, during medical consultations and literature review. Conclusion: Unilateral Nephrectomy proved to be effective in controlling arterial hypertension, improving renal performance and in the evolution of renal insufficiency that is difficult to control from the renovascular root, enabling improvement in the affected individual's quality of life

Effects of Uninephrectomy on Calcium Oxalate Nephrolithiasis in Ethylene Glycol-Treated Rats / 대한비뇨기과학회지

PURPOSE: A renal compensatory hyperfunction after the surgical removal of a contralateral normal kidney includes hyperfiltration and hyperexcretion. These changes in the remaining kidney may increase or decrease the stone-forming potential. The effects of a uninephrectomy (uNX) on stone formation were investigated in an animal model. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300-350gm) were divided into 3 groups (n=10 in each). Group 1 were left untreated and served as the control. Group 2 were fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in their drinking water for 4 weeks without a uNX. Group 3 were fed the same CID for 4 weeks from 2 weeks after the uNX. The stone metabolic study analyzed the excretion rate differences of the lithogenic and inhibitory constituents in the serum and 24-hour urine in the rats. The crystal deposits were examined by polarizing microscopy and the renal calcium content was measured by atomic absorption spectroscopy. RESULTS: There was a significant difference between the control group (56.44+/-4.90 ng/gm) and the CID-treated groups in terms of the renal calcium content (p< 0.01). In addition, the magnitude of the increase was significantly higher in group 3 (2875.50+/-1783.90 ng/gm) than in group 2 (1053.54+/-866.71ng/gm) (p< 0.05). The mean grade of the crystal deposit in group 3 (3.60 +/- 0.70) was markedly higher than in group 2 (2.40 +/- 1.35) (p< 0.05). When comparing group 2 and 3, the serum creatinine level increased significantly (p< 0.05), whereas the creatinine clearance and 24-hour urinary excretion of citrate decreased significantly (p< 0.05). CONCLUSIONS: The results suggest that uNX increases the stone-forming potential of the remaining kidney in the presence of other lithogenic risk factors.

Effects of Uninephrectomy on Calcium Oxalate Nephrolithiasis in Ethylene Glycol-Treated Rats / 대한비뇨기과학회지

PURPOSE: A renal compensatory hyperfunction after the surgical removal of a contralateral normal kidney includes hyperfiltration and hyperexcretion. These changes in the remaining kidney may increase or decrease the stone-forming potential. The effects of a uninephrectomy (uNX) on stone formation were investigated in an animal model. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300-350gm) were divided into 3 groups (n=10 in each). Group 1 were left untreated and served as the control. Group 2 were fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in their drinking water for 4 weeks without a uNX. Group 3 were fed the same CID for 4 weeks from 2 weeks after the uNX. The stone metabolic study analyzed the excretion rate differences of the lithogenic and inhibitory constituents in the serum and 24-hour urine in the rats. The crystal deposits were examined by polarizing microscopy and the renal calcium content was measured by atomic absorption spectroscopy. RESULTS: There was a significant difference between the control group (56.44+/-4.90 ng/gm) and the CID-treated groups in terms of the renal calcium content (p< 0.01). In addition, the magnitude of the increase was significantly higher in group 3 (2875.50+/-1783.90 ng/gm) than in group 2 (1053.54+/-866.71ng/gm) (p< 0.05). The mean grade of the crystal deposit in group 3 (3.60 +/- 0.70) was markedly higher than in group 2 (2.40 +/- 1.35) (p< 0.05). When comparing group 2 and 3, the serum creatinine level increased significantly (p< 0.05), whereas the creatinine clearance and 24-hour urinary excretion of citrate decreased significantly (p< 0.05). CONCLUSIONS: The results suggest that uNX increases the stone-forming potential of the remaining kidney in the presence of other lithogenic risk factors.

Changes of Renal Calcium Content and CaOx Crystal Deposit after Unilateral Nephrectomy in Rats / 대한비뇨기과학회지

PURPOSE: The surgical removal of normal kidney elicits dramatic changes in the remaining kidney. Changes in urinary excretion of lithogenlc substances and urinary inhibitor may increase or decrease the stone-forming potential. The aim of this study was to determine if unilateral nephrectomy could enhance urinary calculi formation in animal model. MATERIALS AND METHODS: Adult male rats were divided randomly into 3 groups. Group 1(n=5) were fed with pellet and tap water for 4 weeks without nephrectomy Group 2(n=5) were fed with the same pellet and 0.8% ethylene glycol plus 1% ammonium chloride in drinking water for 4 weeks without nephrectomy Group 3(n=5) were fed with the same pellet and the same lithogenic diet from 2 weeks after uninephrectomy for 4 weeks. Each right kidney was harvested after 4 weeks feeding. One half of the each kidney were fixed for H & E stain to examine crystal deposits. The remaining half of the kidneys were treated with 12N KOH and 6N HCI for the measurement of calcium content with atomic absorption spectrophotometer. About 3-5cc of blood was collected from the inferior vela cava for determinations of serum creatinine, calcium, magnesium and phosphorus & chloride. Urine was collected over a 24 hour interval before and after lithogenic diet, and urine volume, 24-hour urinary excretions of oxalate, citrate, uric acid, calcium, magnesium, phosphate, sodium, potassium, chloride, and creatinine were measured. RESULTS: There was a significant difference between group 1(0.243 +/- 0.014mmo1/kg) and lithogenic diet groups(group 2 and group 3 in calcium content(p 0.05). There were no calcium oxalate crystal deposit in the group 1, but there were about 2-5 crystal deposits with partially polarized light microscope( x 100) in group 2 and group 3, and there was no significant difference between group 2 and group 3. After taking lithogenic diet, the serum creatinine, serum magnesium, serum phosphors, urine pH & 24-hour urinary excretions of oxalate increased significantly in group 2 and group 3, whereas creatinine clearance & 24-hour urinary excretions of calcium, sodium, potassium, chloride, citrate decreased significantly in the same groups(p < 0.05). But, there were no significant difference of serum calcium, chloride, and 24-hour urinary excretions of magnesium, uric acid among three groups after 4 weeks feeding. CONCLUSIONS: Unilateral nephrectomy would not increase stone forming potential.