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Neonatology pp 1955-1996 | Cite as

Diagnosis and Treatment of Renal and Urinary Tract Malformations in Newborns

  • Vassilios Fanos
  • Marco Zaffanello
  • Michele Mussap
Reference work entry

Abstract

Renal and urinary tract malformations in newborns are mostly congenital anomalies with genetic causes and can be classified according to location. Renal agenesis can be detected by ultrasound, and it can be isolated or part of a syndrome. Abnormal migration and positioning of the kidney during embryogenesis can result in malrotation or malpositioning. Polycystic kidney disease (PKD) is a genetic disorder presenting different pattern of inheritance: autosomal recessive polycystic kidney disease (ARPKD), autosomal dominant polycystic kidney disease (ADPKD), and nephronophthisis/ medullary cystic kidney disease. ARPKD is associated with congenital hepatic fibrosis leading to the development of portal hypertension. Obstructive uropathy is also common in the newborn and can be divided as high and low tract obstruction, among which pelvic-ureteric junction obstruction and posterior urethral valves (PUVs) are respectively the most common causes. Obstructive hydrouretero-nephrosis may include primary or congenital vesicoureteric junction obstruction (VUJO) and a secondary form of VUJO (i.e., ureterocele, retroperitoneal fibrosis, calculus). Vescico-ureteric reflux (VUR) is the retrograde flow of urine into the upper urinary tract, often primary or associated with dysplastic kidneys. Moreover, VUR can be a result of ureteral duplications, ectopia, and ureterocele. Hypospadias is one of the most frequent genital malformations and results from abnormal penile and urethral development. Ultrasound (US) screening for fetal anomalies is the major imaging tool. For postnatal causes, imaging investigations include US, computerized-tomography, and magnetic resonance imaging. The usual recommendation is that renography should be delayed until the age of 4 weeks, because of the immaturity of nephrons in newborns.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Vassilios Fanos
    • 1
  • Marco Zaffanello
    • 4
    • 2
    • 5
  • Michele Mussap
    • 3
  1. 1.Department of SurgeryNeonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, AOU and University of CagliariCagliariItaly
  2. 2.Department of Life and Reproduction Sciences Pediatric SectionUniversity of VeronaVeronaItaly
  3. 3.Laboratory MedicineOspedale Policlinico San MartinoGenoaItaly
  4. 4.Department of Surgical Sciences, Dentistry, Gynecology and PediatricsUniversity of VeronaVeronaItaly
  5. 5.Department of SurgeryUniversity of CagliariCagliariItaly

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