Objectives: We evaluated children with pelvic kidney and their follow-up according to initial renal function and the appearance of concomitant urological pathologies. Patients and Methods: In a retrospective analysis of our case notes, we studied 17 children (8 female, 9 male) who had been referred to our department for further investigation between 1994 and 2002 in whom we found a pelvic ectopic kidney. Results: The mean age of the patients at the initial investigation was 72.5 months (range, 2-156 months); 10/17 were referred to our department for further investigation and clarification of a suspected renal agenesis, the remaining 7/17 children presented with urinary tract infection (1/17), nocturnal enuresis (3/17), hypertension (1/17) and phimosis (2/17). The nuclear medicine scan performed at the initial investigation in 14/17 children revealed that the function of the ectopic kidney had been reduced to one-third in contrast to two-thirds for the orthotopic kidney (p = 0.002). Overall global renal clearance was normal in all children. In 8/17 patients, the ongoing control nuclear investigations, on average 26.2 months later, revealed unchanged overall function of the kidney, we did, however, find a slight improvement of the ectopic renal function as compared to initial investigation which was not statistically significant (p = 0.683). In the period of this retrospective analysis, surgical correction of an accompanying pathology was performed in 23.5% (4/17) of the children (vesico-ureteteric reflux operation in two cases, surgery for pelvic ureteric junction obstruction in one case, and nephroureterectomy in one case of a nonfunctioning-kidney). A left-sided pelvic kidney was seen in 64.7% (11/17) of cases, a right-sided ectopic kidney in 23.5% (4/17), a pelvic fused kidney in 11.7% (2/17), and a solitary left-sided pelvic ectopia with right-sided agenesis in 5.8% (1/17) of cases. Conclusion: In the event of suspected renal agenesis on ultrasonography, the possibility of a pelvic ectopic kidney should always be included in the range of diagnoses. On ultrasonography, the pelvic kidney is best visualized inferior to the iliac vessels, in the presence of a filled bladder. It is more frequently encountered on the left side. Nearly one-thirds of our patients presented with concomitant pathologies and one quarter needed surgical intervention. Although the function of the ectopic kidney alone was reduced by 2/3, the overall renal clearance was normal and remained stable in the course of the observation period.
Useful keywords (using NLM MeSH Indexing)
Kidney Function Tests
Find related publications in this database (Keywords)pelvic kidney