Reconsideration of urine culture for the diagnosis of acute pyelonephritis in children: a new challenging method for diagnosing acute pyelonephritis / 소아과

Acute pyelonephritis (APN) should be detected and treated as soon as possible to reduce the risk of the development of acquired renal scarring. However, in the medical field, urine culture results are not available or considered when the prompt discrimination of APN is necessary and empirical treatment is started. Furthermore, urine culture cannot discriminate APN among children with febrile urinary tract infection (UTI) (pyelitis, lower UTI with other fever focus). Therefore, the usefulness of urine culture for diagnostic purposes is small and the sampling procedure is invasive. Congenital hypoplastic kidney is the most common cause of chronic kidney injury in children. Thus, it is desirable that a main target be detected as early as possible when imaging studies are performed in children with APN. However, if APN does not recur, no medical or surgical treatment or imaging studies would be needed because the acquired renal scar would not progress further. Therefore, the long-term prognosis of APN in young children, particularly infants, depends on the number of recurrent APN, not other febrile UTI. New methods that enable prompt, practical, and comfortable APN diagnosis in children are needed as alternatives to urinary catheterization for urine culture sampling.

A Case of Renal Hypertension with Unilateral Renal Artery Stenosis and Contralateral Hypoplastic Kidney

Hypertension may be due to either vascular (renal artery stenosis) or nonvascular (urologic) causes in hypertensives with unilateral small kidneys. Generally, the occurrence of hypertension in association with difference in kidney size suggests the presence of prolonged renal artery stenosis. This condition can result in decreased volume of the poststenotic kidney. Another cause of small kidneys is unilateral renal agenesis, renal dysplasia with or without reflux, tubular obstruction, and hydronephrosis. Hypertension can be attributed to abnormal-sized kidneys. Nephrectomy of the small kidney or correction of the stenotic artery normalizes blood pressure. De Jong and associates reported 8 cases of young women thought to have hypertension caused by unilateral renal parenchymal disease. Renal angiography, however, disclosed significant renal artery stenosis in the contralateral kidney of all 8 patients. Revascularization of the kidney with stenotic lesions cured the hypertension. The data suggests that in patients suspected of having hypertension caused by unilateral renal parenchymal disease, not only should renal venous renins be determined, but nephrectomy should not be peformed as well until renal angiography has been performed to exclude contralateral renal artery stenosis. We report a case of unilateral renal artery stenosis with contralateral hypoplastic kidney in a 22 year old woman; hypertension was corrected by successful anastomosis of the stenotic artery without nephrectomy of the contralateral small kidney.

Unilateral Single Vaginal Ectopic Ureter with Ipsilateral Hypoplastic Kidney: A Case Report / 대한비뇨기과학회지

To date, the unilateral single vaginal ectopic ureter has been regarded as the rarest form of ureteral ectopia because 80 per cent of all ectopic ureters are associated with a duplicated system and most of the ectopic ureters occur in male patients. This malformation may take the form of but is not limited to any ombination of abnormal development of the mesonephric and paramesonephric ducts. We report a case of unilateral single vaginal ectopic ureter with ipsilateral hypoplastic kidney in a 9 year-old female patient who has been suffered from diaper dermatitis due to persistent urinary incontinence since birth.

A Case of Hypoplastic Ectopic Kidney in Pelvic Cavity / 대한비뇨기과학회지

The Author's are presenting a case of hypoplastic ectopic kidney in pelvic cavity with short ureteral length and ectopic ureteral orifice in vaginal vestibulum. The size of ectopic kidney was unusually small, chest nut size, as dislocated kidney congenitally which made put more effort then usual diagnostic approach to locate it.