RT Book, Section
A1 Owumi, Winifred A.
A1 Kennedy, William A.
A2 Stevenson, David K.
A2 Cohen, Ronald S.
A2 Sunshine, Philip
SR Print(0)
ID 1109795324
T1 Obstructive Uropathies
T2 Neonatology: Clinical Practice and Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071763769
LK accesspediatrics.mhmedical.com/content.aspx?aid=1109795324
RD 2024/04/24
AB The  urinary  system  is  essential  for  the  elimination  of  metabolic  wastes,  maintenance  of  physiologic  pH,  and  the  preservation  of  fluid  and  electrolyte  homeostasis.  It  also  contributes  to  vital  functions  like  erythropoiesis  and  blood  pressure  control.  Obstruction  in  the  upper  or  lower  urinary  tract  system  can  lead  to  disruption  in  these  vital  body  physiologies  and  can  lead  to  significant  morbidity,  which  may  be  irreversible  and  ultimately  lead  to  mortality.  In  neonates  and  young  children,  reports  have  shown  that  obstruction  of  the  urinary  tract  is  the  most  common  cause  of  renal  insufficiency,  especially  in  boys  under  the  age  of  1,  as  well  as  the  number  1  cause  of  renal  transplantation  in  children.1,  2  The  majority  of  these  obstructive  uropathies  are  congenital  in  nature.  The  neonatal  kidney  is  still  developing,  therefore  obstruction  can  lead  to  alterations  in  the  normal  growth  pattern  and  differentiation  of  the  renal  cells  beginning  in  the  intrauterine  period  and  progressing  postpartum,  ultimately  resulting  in  the  development  of  fibrosis  and  renal  failure.  Obstruction  can  be  limited  to  the  upper  urinary  tract,  the  lower  urinary  tract,  or  a  combination.