Ultrasonido renal en los primeros seis meses de vida / Renal ultrasound in the first six months of life

Introducción: Las malformaciones congénitas renales y de las vías urinarias, constituyen la causa más frecuente de la enfermedad renal crónica en niños menores de 5 años. La ultrasonografía renal, se contempla en la actualidad, en el estudio inicial ante la sospecha de enfermedad renal crónica secundaria a malformaciones congénitas renales y de vías urinarias. Objetivo: Identificar los hallazgos sonográficos sugestivos de anomalías renales en los primeros seis meses de vida. Métodos: Estudio descriptivo transversal en niños nacidos entre julio de 2014 y junio de 2015 en el municipio de Santa Clara, con ultrasonido renal prenatal normal. A los 672 niños estudiados, previo consentimiento informado, se les realizó ultrasonido renal en algún momento dentro de los seis primeros meses de vida, lo que permitió identificar a los niños con alteraciones sonográficas sugerentes de algún tipo de anomalías del desarrollo renal. Se continuaron los estudios, según protocolos establecidos, para definir el tipo de malformación congénita renal y de vías urinarias. Resultados: El 5,95 por ciento (40 pacientes) presentaron alguna alteración sonográfica. La hidronefrosis se identificó en el 27,50 por ciento. La ectopia renal y la asimetría renal estuvieron presentes en el 15,00 por ciento de los pacientes. El 10,00 por ciento presentó agenesia renal. El 22, 5 por ciento de los pacientes con hidronefrosis tenían reflujo vesicoureteral. Conclusiones: La hidronefrosis constituye una alteración sonográfica frecuente en pacientes con malformaciones congénitas renales, sobre todo del tipo de reflujo vesicoureteral. Dentro de las alteraciones de tamaño, posición y forma, la ectopia renal constituye la anomalía del desarrollo renal más frecuente(AU)

Introduction: Renal congenital and urinary tract´s malformations represent the most frequent cause of chronical kidney disease in children under five years old. The renal ultrasound it is nowadays included in the initial study while suspecting chronical kidney disease as a consequence of renal congenital and urinary tract´s malformations. Objective: To identify sonographic findings that suggest renal anomalies in the first six months of life. Methods: Descriptive cross-sectional study in children that were born from July, 2014 to June, 2015 in Santa Clara municipality having a normal prenatal renal ultrasound. The 672 children studied with previous informed consent had a renal ultrasound in the first six months of life which allowed to identify the children with sonographic alterations suggestive to any kind of renal development´s anomalies. The studies were conducted under the established protocols to define the kind of renal congenital and urinary tract´s malformation. Results: 5.5 percent (40 patients) presented any kind of sonographic alteration. Hydronephrosis was identified in 27.50 percent of the patients. Renal ectopy and renal asymmetry were present in the 15.00 percent of the patients. 10.00 percent presented renal agenesis. 22.5 percent of the patients with hydronephrosis had vesicoureteral reflux. Conclusions: Hydronephrosis represents a frequent sonographic alteration in patients with congenital renal malformations, mostly the vesicoureteral reflux type. Among the size, position and shape alterations, renal ectopy is the most frequent renal development´s anomaly(AU)

Hallazgo anatomopatológico en un paciente adulto con una malformación renal congénita o anomalía de fusión / Pathological finding in an adult patient with a congenital renal malformation or fusion anomaly

Se describe el caso clínico de un paciente adulto con antecedentes de alcoholismo e hipertensión, quien falleció fuera de la institución hospitalaria y al realizarle la autopsia se encontró una ectopia renal cruzada con fusión, así como un único sistema excretor.

The case report of an adult patient with a history of alcoholism and hypertension who died outside of the hospital institution is described, and when carrying out the autopsy a cross renal ectopia with coalition, as well as only one excretory system were found.

Agenesia renal unilateral e criptorquidismo ipsilateral em um felino: relato de caso / Unilateral renal agenesis and ipsilateral cryptorchidism in a cat: case report

A agenesia renal é uma afecção congênita rara na espécie felina, frequentemente associada a uma malformação reprodutiva. O presente trabalho relata o caso de um felino com agenesia renal unilateral associada a criptorquidismo ipsilateral, com ênfase no diagnóstico, tratamento e acompanhamento. O paciente foi conduzido ao Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul para avaliação de criptorquidismo. A agenesia renal foi um achado durante a ecografia abdominal do felino. Durante a laparotomia, foi confirmada a ausência do rim e ureter direito, hipertrofia do rim esquerdo e presença de um testículo ectópico. O paciente teve alta após a recuperação anestésica e se mantém clinicamente estável, transcorridos seis meses da cirurgia. A agenesia renal unilateral é uma condição compatível com a vida, contanto que o rim existente apresente funcionamento aceitável. Assim, sugere-se que a possibilidade de rim único em felinos criptorquidas deve ser investigada sempre que possível, tendo em vista a alta correlação entre essas malformações, e objetivando um acompanhamento da função renal do paciente ao longo da vida.(AU)

Renal agenesis is a rare disorder in feline species, commonly associated with reproductive malformation. This study aims to report the case of a cat with unilateral renal agenesis combined with ipsilateral cryptorchidism, emphasizing the diagnosis, treatment and patient follow up. The patient was taken to the Veterinary Hospital of the Federal University of Rio Grande do Sul to evaluate the cryptorchidism. The renal agenesis was an incidental finding during the abdominal ultrasound. At laparotomy, the absence of the right kidney and ureter was confirmed, hypertrophy of the left kidney and the presence of an ectopic testicle were found. The patient was discharged after recovering from anesthesia and remains clinically stable six months after surgery. The unilateral renal agenesis is a life compatible condition as long as the existing kidney has an acceptable performance. Therefore, it is suggested that the chance of a single kidney in cats whit cryptorchidism should be investigated, given the correlation between these malformations, and aiming to monitor renal function throughout the life of the patient.(AU)