Hydronephrosis, because of ureteropelvic junction obstruction, is a typical condition in newborns with an incidence of approximately 0.5-1%. Over the past decade, the surgical management of non-symptomatic hydronephrosis has become much more conservative, and the long-term physiological effects of this new policy are unclear. The goal of this dissertation was to evaluate if there exists a link between hydronephrosis and the development of hypertension. Hydronephrosis was induced by partial ureteral obstruction in 3-week old rats or mice. In the adult animals, blood pressure was calculated telemetrically during different sodium conditions and the renal function was examined. Both species developed salt-sensitive hypertension and histopathological changes (i.e. fibrosis, inflammation, glomerular and tubular changes) that linked with the degree of hydronephrosis. An abnormal renal excretion pattern with increased diuresis and impaired urine concentrating ability was noticed in hydronephrosis…
Contents
INTRODUCTION
Kidney function and Autoregulation
Renal hypertension
Hydronephrosis
Incidence and aetiology
Diagnostics
Hydronephrosis and changes in renal function
Treatment
Hydronephrosis and Hypertension
Experimental findings
AIMS
MATERIAL AND METHODS
Animals
Study protocols
Creation of partial ureteral obstruction (Studies I-IV)
Telemetry – Implantation (Studies I-IV)
Telemetry – Measurements (Studies I-IV)
Classification of hydronephrosis (Studies I-IV)
Sampling and renin assay (Studies I-IV)
Ipsi- and contralateral nephrectomy (Study II)
Ureterovesicostomy (Study II)
Renal excretion measurements (Studies III and IV)
L-arginine, ADMA and SDMA measurements (Study IV)
Western blotting for nitric oxide synthases (Study IV)
Histology (Studies III and IV)
Stereology (Study III)
Stop-flow pressure measurements (Study IV)
Statistical analysis
Ethics
RESULTS
Study I
Study II
Study III
Study IV
DISCUSSION
Relief of chronic partial ureteral obstruction
Renal excretion measurements
Renin Angiotensin System
Histopathological changes
L-NAME and blood pressure
L-arginine and blood pressure…
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