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Pathology - Obstructive nephropathy
Definition: Renal impairment resulting from blockage in the urinary tract. Epidemiology: Primarily observed in youngsters (attributable to congenital urinary tract defects) and elderly males (resulting from prostatic hyperplasia). Aetiology • Obstruction can manifest at any location within the urinary system Common etiologies encompass urinary calculi, pelviureteric junction obstruction, prostatic hyperplasia, urothelial tumors, and ureteral compression by abdominal or pelvic masses.
Pathogenesis • Renal injury is mostly considered a pressure-related condition, although concurrent infection may also play a role.
Presentation • The clinical manifestations are varied. contingent upon the severity of the condition and its laterality. • Patients may be asymptomatic or exhibit hypertension, polyuria, or renal failure.
Macroscopy • The kidney is diminutive and atrophied, exhibiting hydronephrosis, widespread calyceal dilatation, papillary blunting, and cortical thinning.
Histopathology • The renal parenchyma exhibits characteristics of chronic pyelonephritis, including significant tubulointerstitial fibrosis and tubular atrophy. • Atrophic tubules are frequently dilated and contain proteinaceous material, a phenomenon referred to as 'thyroidization.' • The collecting system has significant chronic inflammation characterized by lymphoid clusters and follicles. • Remaining glomeruli may display hypertrophy and subsequent glomerulosclerosis.
The phrase ‘chronic pyelonephritis’ denotes a set of clinical characteristics that are not exclusive to obstructive nephropathy and may also occur in other conditions, such as reflux nephropathy. Distinction is typically achievable based on the clinical presentation and scarring pattern.
Prognosis: Patients with substantial bilateral illness are at risk of experiencing increasing renal impairment.


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