Skip to main content

Advertisement

Log in

Current perspectives on congenital obstructive nephropathy

  • Review
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Congenital obstructive nephropathy is the leading cause of chronic renal disease in children. As a result, it represents a tremendous societal burden in terms of morbidity and mortality, as well as in health care expenses of caring for children with chronic kidney disease and end-stage renal disease. The various diagnostic, prognostic, and therapeutic challenges associated with congenital obstructive nephropathy highlight the importance of developing effective experimental models for studying this disease process. In this review, we define the clinical entity that is congenital obstructive nephropathy, outline the current standards of diagnosis and care, and discuss the utilization of current experimental models designed to help clarify some of the clinical conundrums associated with this important disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Woolf AS, Thiruchelvam N (2001) Congenital obstructive uropathy: its origin and contribution to end-stage renal disease in children. Adv Ren Replace Ther 8:157–163

    Article  CAS  PubMed  Google Scholar 

  2. Ewalt DH, Bauer SB (1996) Pediatric neurourology. Urol Clin North Am 23:501–509

    Article  CAS  PubMed  Google Scholar 

  3. Vidal I, Heloury Y, Ravasse P, Lenormand L, Leclair MD (2009) Severe bladder dysfunction revealed prenatally or during infancy. J Pediatr Urol 5:3–7

    Article  PubMed  Google Scholar 

  4. Woodhouse CR, Ransley PG, Innes-Williams D (1982) Prune belly syndrome–report of 47 cases. Arch Dis Child 57:856–859

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Collins AJ, Foley R, Herzog C, Chavers B, Gilbertson D, Ishani A, Kasiske B, Liu J, Mau LW, McBean M, Murray A, St Peter W, Xue J, Fan Q, Guo H, Li Q, Li S, Peng Y, Qiu Y, Roberts T, Skeans M, Snyder J, Solid C, Wang C, Weinhandl E, Zaun D, Zhang R, Arko C, Chen SC, Dalleska F, Daniels F, Dunning S, Ebben J, Frazier E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Constantini E, Everson S, Eggers P, Agodoa L (2008) Excerpts from the united states renal data system 2007 annual data report. Am J Kidney Dis 51:S1–S320

    PubMed  Google Scholar 

  6. North American Pediatric Renal Transplant Cooperative Study (2008) Annual report. Available at: https://webemmescom/study/ped/annlrept/annlrept.html (Accessed July 7, 2010)

  7. Economou G, Egginton JA, Brookfield DS (1994) The importance of late pregnancy scans for renal tract abnormalities. Prenat Diagn 14:177–180

    Article  CAS  PubMed  Google Scholar 

  8. Riccipetitoni G, Chierici R, Tamisari L, De Castro R, Manfredi S, Veroni G, Susini P, Georgacopulo P, Vigi V (1992) Postnatal ultrasound screening of urinary malformations. J Urol 148:604–605

    Article  CAS  PubMed  Google Scholar 

  9. Wiesel A, Queisser-Luft A, Clementi M, Bianca S, Stoll C (2005) Prenatal detection of congenital renal malformations by fetal ultrasonographic examination: an analysis of 709, 030 births in 12 European countries. Eur J Med Genet 48:131–144

    Article  CAS  PubMed  Google Scholar 

  10. Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Innocenti ML, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L, Ghiggeri GM (2009) Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int 76:528–533

    Article  PubMed  Google Scholar 

  11. Farnham SB, Adams MC, Brock JW 3rd, JCt P (2005) Pediatric urological causes of hypertension. J Urol 173:697–704

    Article  PubMed  Google Scholar 

  12. Gillenwater JY, Westervelt FB Jr, Vaughan ED Jr, Howards SS (1975) Renal function after release of chronic unilateral hydronephrosis in man. Kidney Int 7:179–186

    Article  CAS  PubMed  Google Scholar 

  13. Woodward M, Frank D (2002) Postnatal management of antenatal hydronephrosis. BJU Int 89:149–156

    Article  CAS  PubMed  Google Scholar 

  14. Payabvash S, Kajbafzadeh AM, Tavangar SM, Monajemzadeh M, Sadeghi Z (2007) Myocyte apoptosis in primary obstructive megaureters: the role of decreased vascular and neural supply. J Urol 178:259–264, discussion 264

    Article  PubMed  Google Scholar 

  15. Yoon JY, Kim JC, Hwang TK, Yoon MS, Park YH (1998) Collagen studies for pediatric ureteropelvic junction obstruction. Urology 52:494–497, discussion 497-498

    Article  CAS  PubMed  Google Scholar 

  16. Hosgor M, Karaca I, Ulukus C, Ozer E, Ozkara E, Sam B, Ucan B, Kurtulus S, Karkiner A, Temir G (2005) Structural changes of smooth muscle in congenital ureteropelvic junction obstruction. J Pediatr Surg 40:1632–1636

    Article  PubMed  Google Scholar 

  17. Pohl HG, Joyce GF, Wise M, Cilento BG Jr (2007) Vesicoureteral reflux and ureteroceles. J Urol 177:1659–1666

    Article  PubMed  Google Scholar 

  18. Bernardes LS, Aksnes G, Saada J, Masse V, Elie C, Dumez Y, Lortat-Jacob SL, Benachi A (2009) Keyhole sign: how specific is it for the diagnosis of posterior urethral valves? Ultrasound Obstet Gynecol 34:419–423

    Article  CAS  PubMed  Google Scholar 

  19. Riedmiller H, Androulakakis P, Beurton D, Kocvara R, Gerharz E (2001) EAU guidelines on paediatric urology. Eur Urol 40:589–599

    Article  CAS  PubMed  Google Scholar 

  20. Agarwal S (1999) Urethral valves. BJU Int 84:570–578

    Article  CAS  PubMed  Google Scholar 

  21. Greenfield SP, Hensle TW, Berdon WE, Wigger HJ (1983) Unilateral vesicoureteral reflux and unilateral nonfunctioning kidney associated with posterior urethral valves–a syndrome? J Urol 130:733–738

    Article  CAS  PubMed  Google Scholar 

  22. Robyr R, Benachi A, Daikha-Dahmane F, Martinovich J, Dumez Y, Ville Y (2005) Correlation between ultrasound and anatomical findings in fetuses with lower urinary tract obstruction in the first half of pregnancy. Ultrasound Obstet Gynecol 25:478–482

    Article  CAS  PubMed  Google Scholar 

  23. Gonzalez R, De Filippo R, Jednak R, Barthold JS (2001) Urethral atresia: long-term outcome in 6 children who survived the neonatal period. J Urol 165:2241–2244

    Article  CAS  PubMed  Google Scholar 

  24. Herndon CD, Casale AJ (2002) Early second trimester intervention in a surviving infant with postnatally diagnosed urethral atresia. J Urol 168:1532–1533

    Article  PubMed  Google Scholar 

  25. Reinberg Y, Chelimsky G, Gonzalez R (1993) Urethral atresia and the prune belly syndrome. Report of 6 cases. Br J Urol 72:112–114

    Article  CAS  PubMed  Google Scholar 

  26. Arena S, Romeo C, Borruto FA, Racchiusa S, Di Benedetto V, Arena F (2009) Anterior urethral valves in children: an uncommon multipathogenic cause of obstructive uropathy. Pediatr Surg Int 25:613–616

    Article  PubMed  Google Scholar 

  27. Gupta DK, Srinivas M (2000) Congenital anterior urethral diverticulum in children. Pediatr Surg Int 16:565–568

    Article  CAS  PubMed  Google Scholar 

  28. Paulhac P, Fourcade L, Lesaux N, Alain JL, Colombeau P (2003) Anterior urethral valves and diverticula. BJU Int 92:506–509

    Article  CAS  PubMed  Google Scholar 

  29. Rawat J, Khan TR, Singh S, Maletha M, Kureel S (2009) Congenital anterior urethral valves and diverticula: diagnosis and management in six cases. Afr J Paediatr Surg 6:102–105

    Article  PubMed  Google Scholar 

  30. Routh JC, Huang L, Retik AB, Nelson CP (2010) contemporary epidemiology and characterization of newborn males with prune belly syndrome. Urology 76:44–48

    Article  PubMed  Google Scholar 

  31. Straub E, Spranger J (1981) Etiology and pathogenesis of the prune belly syndrome. Kidney Int 20:695–699

    Article  CAS  PubMed  Google Scholar 

  32. Pagon RA, Smith DW, Shepard TH (1979) Urethral obstruction malformation complex: a cause of abdominal muscle deficiency and the "prune belly". J Pediatr 94:900–906

    Article  CAS  PubMed  Google Scholar 

  33. Strand WR (2004) Initial management of complex pediatric disorders: prunebelly syndrome, posterior urethral valves. Urol Clin North Am 31:399–415, vii

    Article  PubMed  Google Scholar 

  34. Ismaili K, Hall M, Donner C, Thomas D, Vermeylen D, Avni FE (2003) Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population. Am J Obstet Gynecol 188:242–246

    Article  PubMed  Google Scholar 

  35. De Kort EH, Bambang Oetomo S, Zegers SH (2008) The long-term outcome of antenatal hydronephrosis up to 15 millimetres justifies a noninvasive postnatal follow-up. Acta Paediatr 97:708–713

    Article  PubMed  Google Scholar 

  36. Hutton KA, Thomas DF, Arthur RJ, Irving HC, Smith SE (1994) Prenatally detected posterior urethral valves: is gestational age at detection a predictor of outcome? J Urol 152:698–701

    Article  CAS  PubMed  Google Scholar 

  37. Oliveira EA, Diniz JS, Cabral AC, Pereira AK, Leite HV, Colosimo EA, Vilasboas AS (2000) Predictive factors of fetal urethral obstruction: a multivariate analysis. Fetal Diagn Ther 15:180–186

    Article  CAS  PubMed  Google Scholar 

  38. Sarhan O, Zaccaria I, Macher MA, Muller F, Vuillard E, Delezoide AL, Sebag G, Oury JF, Aigrain Y, El-Ghoneimi A (2008) Long-term outcome of prenatally detected posterior urethral valves: single center study of 65 cases managed by primary valve ablation. J Urol 179:307–312, discussion 312-303

    Article  PubMed  Google Scholar 

  39. Morris RK, Malin GL, Khan KS, Kilby MD (2009) Antenatal ultrasound to predict postnatal renal function in congenital lower urinary tract obstruction: systematic review of test accuracy. BJOG 116:1290–1299

    Article  CAS  PubMed  Google Scholar 

  40. Decramer S, ZUR P, Wittke S, Mischak H, Bascands JL, Schanstra JP (2008) Identification of urinary biomarkers by proteomics in newborns: use in obstructive nephropathy. Contrib Nephrol 160:127–141

    Article  CAS  PubMed  Google Scholar 

  41. Morris RK, Quinlan-Jones E, Kilby MD, Khan KS (2007) Systematic review of accuracy of fetal urine analysis to predict poor postnatal renal function in cases of congenital urinary tract obstruction. Prenat Diagn 27:900–911

    Article  CAS  PubMed  Google Scholar 

  42. Carlstrom M (2010) Causal link between neonatal hydronephrosis and later development of hypertension. Clin Exp Pharmacol Physiol 37:e14–e23

    Article  CAS  PubMed  Google Scholar 

  43. Ansari MS, Gulia A, Srivastava A, Kapoor R (2010) Risk factors for progression to end-stage renal disease in children with posterior urethral valves. J Pediatr Urol 6:261–264

    Article  CAS  PubMed  Google Scholar 

  44. DeFoor W, Clark C, Jackson E, Reddy P, Minevich E, Sheldon C (2008) Risk factors for end stage renal disease in children with posterior urethral valves. J Urol 180:1705–1708, discussion 1708

    Article  PubMed  Google Scholar 

  45. Heikkila J, Rintala R, Taskinen S (2009) Vesicoureteral reflux in conjunction with posterior urethral valves. J Urol 182:1555–1560

    Article  PubMed  Google Scholar 

  46. Neild GH (2009) What do we know about chronic renal failure in young adults? II. Adult outcome of pediatric renal disease. Pediatr Nephrol 24:1921–1928

    Article  PubMed  Google Scholar 

  47. Wuhl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Moller K, Wigger M, Peruzzi L, Mehls O, Schaefer F (2009) Strict blood-pressure control and progression of renal failure in children. N Engl J Med 361:1639–1650

    Article  PubMed  Google Scholar 

  48. Ardissino G, Vigano S, Testa S, Dacco V, Paglialonga F, Leoni A, Belingheri M, Avolio L, Ciofani A, Claris-Appiani A, Cusi D, Edefonti A, Ammenti A, Cecconi M, Fede C, Ghio L, La Manna A, Maringhini S, Papalia T, Pela I, Pisanello L, Ratsch IM (2007) No clear evidence of ACEi efficacy on the progression of chronic kidney disease in children with hypodysplastic nephropathy–report from the ItalKid Project database. Nephrol Dial Transplant 22:2525–2530

    Article  PubMed  Google Scholar 

  49. Kidney Disease Outcomes Quality Initiative (2004) K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis 43:S1–S290

    Google Scholar 

  50. Hale JM, Wood DN, Hoh IM, Neild GH, Bomanji JB, Chu A, Woodhouse CR (2009) Stabilization of renal deterioration caused by bladder volume dependent obstruction. J Urol 182:1973–1977

    Article  PubMed  Google Scholar 

  51. Roth KS, Carter WH Jr, Chan JC (2001) Obstructive nephropathy in children: long-term progression after relief of posterior urethral valve. Pediatrics 107:1004–1010

    Article  CAS  PubMed  Google Scholar 

  52. Holmdahl G, Sillen U (2005) Boys with posterior urethral valves: outcome concerning renal function, bladder function and paternity at ages 31 to 44 years. J Urol 174:1031–1034, discussion 1034

    Article  PubMed  Google Scholar 

  53. Kousidis G, Thomas DF, Morgan H, Haider N, Subramaniam R, Feather S (2008) The long-term outcome of prenatally detected posterior urethral valves: a 10 to 23-year follow-up study. BJU Int 102:1020–1024

    Article  PubMed  Google Scholar 

  54. Nickavar A, Otoukesh H, Sotoudeh K (2008) Validation of initial serum creatinine as a predictive factor for development of end stage renal disease in posterior urethral valves. Indian J Pediatr 75:695–697

    Article  PubMed  Google Scholar 

  55. Ylinen E, Ala-Houhala M, Wikstrom S (2004) Prognostic factors of posterior urethral valves and the role of antenatal detection. Pediatr Nephrol 19:874–879

    PubMed  Google Scholar 

  56. Clark TJ, Martin WL, Divakaran TG, Whittle MJ, Kilby MD, Khan KS (2003) Prenatal bladder drainage in the management of fetal lower urinary tract obstruction: a systematic review and meta-analysis. Obstet Gynecol 102:367–382

    PubMed  Google Scholar 

  57. Carr MC, Kim SS (2010) Prenatal management of urogenital disorders. Urol Clin North Am 37:149–158

    Article  PubMed  Google Scholar 

  58. PLUTO (Percutaneous shunting in Lower Urinary Tract Obstruction) (2010) Trial home page. Available at: https://doi.org/www.plutobhamac.uk/ (Accessed July 7, 2010)

  59. Kilby M, Khan K, Morris K, Daniels J, Gray R, Magill L, Martin B, Thompson P, Alfirevic Z, Kenny S, Bower S, Sturgiss S, Anumba D, Mason G, Tydeman G, Soothill P, Brackley K, Loughna P, Cameron A, Kumar S, Bullen P (2007) PLUTO trial protocol: percutaneous shunting for lower urinary tract obstruction randomised controlled trial. BJOG 114(904–905):e901–e904

    Google Scholar 

  60. Morris RK, Kilby MD (2009) An overview of the literature on congenital lower urinary tract obstruction and introduction to the PLUTO trial: percutaneous shunting in lower urinary tract obstruction. Aust N Z J Obstet Gynaecol 49:6–10

    Article  PubMed  Google Scholar 

  61. Reinberg Y, de Castano I, Gonzalez R (1992) Prognosis for patients with prenatally diagnosed posterior urethral valves. J Urol 148:125–126

    Article  CAS  PubMed  Google Scholar 

  62. Becker A, Baum M (2006) Obstructive uropathy. Early Hum Dev 82:15–22

    Article  PubMed  Google Scholar 

  63. Steinhardt GF, Salinas-Madrigal L, deMello D, Farber R, Phillips B, Vogler G (1994) Experimental ureteral obstruction in the fetal opossum: histologic assessment. J Urol 152:2133–2138

    Article  CAS  PubMed  Google Scholar 

  64. Bing W, Chang S, Hypolite JA, DiSanto ME, Zderic SA, Rolf L, Wein AJ, Chacko S (2003) Obstruction-induced changes in urinary bladder smooth muscle contractility: a role for Rho kinase. Am J Physiol Renal Physiol 285:F990–F997

    Article  PubMed  Google Scholar 

  65. De Souza GM, Costa WS, Bruschini H, Sampaio FJ (2004) Morphological analysis of the acute effects of overdistension on the extracellular matrix of the rat urinary bladder wall. Ann Anat 186:55–59

    Article  PubMed  Google Scholar 

  66. Eroglu E, Kucukhuseyin C, Ayik B, Dervisoglu S, Emir H, Danismend N (2004) Changes in the threshold voltage and alterations of smooth-muscle physiology after bladder outlet obstruction. Eur J Pediatr Surg 14:39–44

    Article  CAS  PubMed  Google Scholar 

  67. Flynn BJ, Mian HS, Cera PJ, Kabler RL, Mowad JJ, Cavanaugh AH, Rothblum LI (2002) Early molecular changes in bladder hypertrophy due to bladder outlet obstruction. Urology 59:978–982

    Article  PubMed  Google Scholar 

  68. Hanai T, Ma FH, Matsumoto S, Park YC, Kurita T (2002) Partial outlet obstruction of the rat bladder induces a stimulatory response on proliferation of the bladder smooth muscle cells. Int Urol Nephrol 34:37–42

    Article  CAS  PubMed  Google Scholar 

  69. Klahr S, Morrissey J (2002) Obstructive nephropathy and renal fibrosis. Am J Physiol Renal Physiol 283:F861–F875

    Article  PubMed  Google Scholar 

  70. Stanton MC, Clement M, Macarak EJ, Zderic SA, Moreland RS (2003) Partial bladder outlet obstruction alters Ca2+ sensitivity of force, but not of MLC phosphorylation, in bladder smooth muscle. Am J Physiol Renal Physiol 285:F703–F710

    Article  CAS  PubMed  Google Scholar 

  71. Thiruchelvam N, Wu C, David A, Woolf AS, Cuckow PM, Fry CH (2003) Neurotransmission and viscoelasticity in the ovine fetal bladder after in utero bladder outflow obstruction. Am J Physiol Regul Integr Comp Physiol 284:R1296–R1305

    Article  CAS  PubMed  Google Scholar 

  72. Bascands JL, Schanstra JP (2005) Obstructive nephropathy: insights from genetically engineered animals. Kidney Int 68:925–937

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Chevalier RL (2006) Pathogenesis of renal injury in obstructive uropathy. Curr Opin Pediatr 18:153–160

    Article  PubMed  Google Scholar 

  74. Esteban V, Lorenzo O, Ruperez M, Suzuki Y, Mezzano S, Blanco J, Kretzler M, Sugaya T, Egido J, Ruiz-Ortega M (2004) Angiotensin II, via AT1 and AT2 receptors and NF-kappaB pathway, regulates the inflammatory response in unilateral ureteral obstruction. J Am Soc Nephrol 15:1514–1529

    Article  CAS  PubMed  Google Scholar 

  75. Inazaki K, Kanamaru Y, Kojima Y, Sueyoshi N, Okumura K, Kaneko K, Yamashiro Y, Ogawa H, Nakao A (2004) Smad3 deficiency attenuates renal fibrosis, inflammation, and apoptosis after unilateral ureteral obstruction. Kidney Int 66:597–604

    Article  CAS  PubMed  Google Scholar 

  76. Cendron M, Horton CE, Karim OM, Takishima H, Haberlik A, Mostwin JL, Gearhart JP (1994) A fetal lamb model of partial urethral obstruction: experimental protocol and results. J Pediatr Surg 29:77–80

    Article  CAS  PubMed  Google Scholar 

  77. Kitagawa H, Pringle KC, Koike J, Zuccollo J, Sato Y, Sato H, Fujiwaki S, Odanaka M, Nakada K (2004) The early effects of urinary tract obstruction on glomerulogenesis. J Pediatr Surg 39:1845–1848

    Article  PubMed  Google Scholar 

  78. Mostwin JL, Karim OM, Van Koeveringe G, Brooks EL (1991) The guinea pig as a model of gradual urethral obstruction. J Urol 145:854–858

    Article  CAS  PubMed  Google Scholar 

  79. O'Connor LT Jr, Vaughan ED Jr, Felsen D (1997) In vivo cystometric evaluation of progressive bladder outlet obstruction in rats. J Urol 158:631–635

    Article  PubMed  Google Scholar 

  80. Kitagawa H, Pringle KC, Koike J, Zuccollo J, Nakada K (2001) Different phenotypes of dysplastic kidney in obstructive uropathy in fetal lambs. J Pediatr Surg 36:1698–1703

    Article  CAS  PubMed  Google Scholar 

  81. McDill BW, Li SZ, Kovach PA, Ding L, Chen F (2006) Congenital progressive hydronephrosis (cph) is caused by an S256L mutation in aquaporin-2 that affects its phosphorylation and apical membrane accumulation. Proc Natl Acad Sci USA 103:6952–6957

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Weide LG, Lacy PE (1991) Hereditary hydronephrosis in C57BL/KsJ mice. Lab Anim Sci 41:415–418

    CAS  PubMed  Google Scholar 

  83. Chang CP, McDill BW, Neilson JR, Joist HE, Epstein JA, Crabtree GR, Chen F (2004) Calcineurin is required in urinary tract mesenchyme for the development of the pyeloureteral peristaltic machinery. J Clin Invest 113:1051–1058

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Gamp AC, Tanaka Y, Lullmann-Rauch R, Wittke D, D'Hooge R, De Deyn PP, Moser T, Maier H, Hartmann D, Reiss K, Illert AL, Von Figura K, Saftig P (2003) LIMP-2/LGP85 deficiency causes ureteric pelvic junction obstruction, deafness and peripheral neuropathy in mice. Hum Mol Genet 12:631–646

    Article  CAS  PubMed  Google Scholar 

  85. Yokoyama H, Wada T, Kobayashi K, Kuno K, Kurihara H, Shindo T, Matsushima K (2002) A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-1 null mutant mice develop renal lesions mimicking obstructive nephropathy. Nephrol Dial Transplant 17(Suppl 9):39–41

    Article  CAS  PubMed  Google Scholar 

  86. Rulli SB, Ahtiainen P, Makela S, Toppari J, Poutanen M, Huhtaniemi I (2003) Elevated steroidogenesis, defective reproductive organs, and infertility in transgenic male mice overexpressing human chorionic gonadotropin. Endocrinology 144:4980–4990

    Article  CAS  PubMed  Google Scholar 

  87. Aoki Y, Mori S, Kitajima K, Yokoyama O, Kanamaru H, Okada K, Yokota Y (2004) Id2 haploinsufficiency in mice leads to congenital hydronephrosis resembling that in humans. Genes Cells 9:1287–1296

    Article  CAS  PubMed  Google Scholar 

  88. Fichtner J, Boineau FG, Lewy JE, Sibley RK, Vari RC, Shortliffe LM (1994) Congenital unilateral hydronephrosis in a rat model: continuous renal pelvic and bladder pressures. J Urol 152:652–657

    Article  CAS  PubMed  Google Scholar 

  89. Miller J, Hesse M, Diemer T, Haenze J, Knerr I, Rascher W, Weidner W (2004) Congenital unilateral ureteropelvic junction obstruction of the rat: a useful animal model for human ureteropelvic junction obstruction? Urology 63:190–194

    Article  PubMed  Google Scholar 

  90. Miyazaki Y, Oshima K, Fogo A, Hogan BL, Ichikawa I (2000) Bone morphogenetic protein 4 regulates the budding site and elongation of the mouse ureter. J Clin Invest 105:863–873

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Nishimura H, Yerkes E, Hohenfellner K, Miyazaki Y, Ma J, Hunley TE, Yoshida H, Ichiki T, Threadgill D, Phillips JA 3rd, Hogan BM, Fogo A, Brock JW 3rd, Inagami T, Ichikawa I (1999) Role of the angiotensin type 2 receptor gene in congenital anomalies of the kidney and urinary tract, CAKUT, of mice and men. Mol Cell 3:1–10

    Article  CAS  PubMed  Google Scholar 

  92. Ingraham SE, Saha M, Carpenter A, Robinson M, Ismail I, Singh S, Hains D, Robinson M, Hirselj DA, Koff S, Bates CM, McHugh KM (2010) Pathogenesis of renal injury in the Megabladder mouse: a genetic model of congenital obstructive nephropathy. Pediatr Res 68:500–507

    Article  PubMed  PubMed Central  Google Scholar 

  93. Singh S, Robinson M, Nahi F, Coley B, Robinson ML, Bates CM, Kornacker K, McHugh KM (2007) Identification of a unique transgenic mouse line that develops megabladder, obstructive uropathy, and renal dysfunction. J Am Soc Nephrol 18:461–471

    Article  CAS  PubMed  Google Scholar 

  94. Parkhouse HF, Barratt TM, Dillon MJ, Duffy PG, Fay J, Ransley PG, Woodhouse CR, Williams DI (1988) Long-term outcome of boys with posterior urethral valves. Br J Urol 62:59–62

    Article  CAS  PubMed  Google Scholar 

  95. Potter EL (1972) Normal and abnormal development of the kidney. Year Book Medical Publishers, Inc., Chicago

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kirk M. McHugh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ingraham, S.E., McHugh, K.M. Current perspectives on congenital obstructive nephropathy. Pediatr Nephrol 26, 1453–1461 (2011). https://doi.org/10.1007/s00467-011-1799-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-011-1799-8

Keywords

Navigation