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Pathophysiology of Renal Obstruction

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Urologic Principles and Practice

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

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Abstract

Renal obstruction is one of the most commonly managed conditions by urologists, and the pathophysiology of this ailment lies at the intersection of urology and nephrology. In the acute setting, this situation can cause significant pain, places the patient at risk for severe sepsis if associated with infection, and when bilateral (or in a solitary kidney) can result in acute renal failure requiring dialysis. When it becomes chronic, tubular atrophy, inflammatory processes resulting in fibrosis, and an irreversible loss of nephrons and renal function will ultimately occur.

Recognizing and treating the condition is of paramount importance for the urologist to prevent renal functional decline. Stratification of renal obstruction into intrinsic and extrinsic etiologies may be helpful in formulating a differential diagnosis and treatment algorithm. An understanding of the long-term sequelae, including renal fibrosis, the role of mast cells, and the effects on renal concentrating ability is important not only for clinical care, but also for the development of future interventions aimed at renal function preservation and restoration.

This chapter will outline the myriad causes of renal obstruction and focus most closely on those aspects of pathophysiology most relevant for the urologist. Pertinent case studies are presented with the relevant surgical considerations taken into account as well as highlighting the key pathophysiologic processes.

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Authors and Affiliations

  1. Department of Urology, University of California San Francisco, San Francisco, CA, USA

    Scott V. Wiener MD & Marshall L. Stoller MD

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  1. Scott V. Wiener MD
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  2. Marshall L. Stoller MD
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Correspondence to Scott V. Wiener MD .

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Editors and Affiliations

  1. Sheffield Teaching Hospitals NHS Foundation, Sheffield, UK

    Christopher R. Chapple

  2. Department of Urology, University of Virginia, Charlottesville, VA, USA

    William D. Steers

  3. Department of Urologic Surgery, University of California, Davis, Sacramento, CA, USA

    Christopher P. Evans

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Wiener, S.V., Stoller, M.L. (2020). Pathophysiology of Renal Obstruction. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_12

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  • DOI: https://doi.org/10.1007/978-3-030-28599-9_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28598-2

  • Online ISBN: 978-3-030-28599-9

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