Clinical and laboratory features of the course of obstructive pyelonephritis in a patient with quantitative kidney abnormality

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Abstract

The kidney duplication is the most common abnormality of the urinary system. In most cases, this condition is an accidental finding on prenatal ultrasound or can be diagnosed when the first clinical manifestations occur. Abnormalities of the upper urinary tract can be detected when examining a patient with arterial hypertension, proteinuria, or renal failure. As an example of the complicated course of the inflammatory process in a patient with quantitative kidney abnormality, a clinical observation of the course of obstructive pyelonephritis against the background of complete obliteration of the lower third of the ureter with the formation of terminal changes in the upper half of the doubled kidney, which led to renovascular hypertension and clinically significant renal failure, is presented. The article describes the clinical manifestations of the disease, laboratory and diagnostic screening, as well as the stages of surgical treatment in a multidisciplinary hospital.

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About the authors

Suleyman I. Suleymanov

RUDN University; The State Healthcare Institution No. 13

Author for correspondence.
Email: s.i.suleymanov@mail.ru
ORCID iD: 0000-0002-0461-9885
SPIN-code: 7168-8819
Scopus Author ID: 57080003900

Dr. Sci. (Med), Professor, Head of the Urological Unit

Russian Federation, 6, Miklukho-Maklaja str, Moscow, 117198; 1/1, Velozavodskaja str, Moscow, 115280

Zieratsho A. Kadyrov

RUDN University

Email: Zieratsho@yandex.ru
ORCID iD: 0000-0002-1108-8138
SPIN-code: 6732-8490
Scopus Author ID: 6602093282

Dr. Sci. (Med), Professor

Russian Federation, 6, Miklukho-Maklaja str, Moscow, 117198

Oganes E. Dilanyan

The State Healthcare Institution No. 13

Email: dilanyan@gmail.com
ORCID iD: 0000-0002-3447-9684

Cand. Sci. (Med), Urologist

Russian Federation, 1/1, Velozavodskaja str, Moscow, 115280

Vladimir S. Ramishvili

RUDN University

Email: ramishvilivladimir60@gmail.com
ORCID iD: 0000-0001-9431-3478
SPIN-code: 7365-9769
Scopus Author ID: 15835683400

Dr. Sci. (Med), Professor

Russian Federation, 6, Miklukho-Maklaja str, Moscow, 117198

Vladislav V. Musohranov

The State Healthcare Institution No. 13

Email: vlad412@mail.ru
ORCID iD: 0000-0003-1336-931X

Cand. Sci. (Med), Urologist

Russian Federation, 1/1, Velozavodskaja str, Moscow, 115280

Alexander S. Babkin

The State Healthcare Institution No. 13

Email: alexbabkin3004@mail.ru
ORCID iD: 0000-0003-1570-1793

Urologist

Russian Federation, 1/1, Velozavodskaja str, Moscow, 115280

References

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Supplementary files

Supplementary Files
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1. Fig. 1. MSCT of the kidneys with intravenous bolus contrast in a patient with congenital quantitative kidney anomaly complicated by terminal ureterohydronephrosis of the upper half of an incompletely doubled left kidney: a – frontal projection; b – sagittal projection. Arrows indicate a dilated ureter

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2. Fig. 2. Nephroscintigram of a patient with congenital quantitative kidney anomaly complicated by terminal ureterohydronephrosis of the upper half of an incompletely duplicated left kidney

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3. Fig. 3. Videoendoscopic heminephrureterectomy on the left: a – the stage of mobilization of the ureters (1 – unchanged ureter of the lower half of the doubled left kidney, 2 – dilated pelvis of the upper half of the doubled left kidney, 3 – dilated ureter of the upper half of the doubled left kidney); b – the stage of mobilization of the terminally changed segment of the left kidney (1 – upper pole of the doubled left kidney, 2 – pelvis of the upper half of the doubled left kidney; 3 – left renal artery, 4 – left renal vein); с – the stage of resection of the terminally changed segment of the upper half of the doubled left kidney (1 – the edge of the resection, 2 – the resected segment of the doubled left kidney)

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4. Fig. 4. Microscope specimen: a – the resected area of the left kidney, hematoxylin-eosin, ×100 (1 – focal fibrosis, 2 – hemorrhages, 3 – foci of lymphohistiocytic infiltration with an admixture of segmented leukocytes; b – the resected section of the ureter, hematoxylin-eosin, ×100 (1 – the wall of the ureter with hemorrhages, 2 – granulations, flattened mucosa)

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