Renal hypoplasia is an underdevelopment of one or both kidneys that occurs during embryonic development. It can be unilateral, affecting one kidney, or bilateral, affecting both kidneys. Unilateral hypoplasia may cause hypertension in childhood while bilateral hypoplasia can lead to chronic renal failure in the first decade of life. Diagnosis is typically made through ultrasound, CT scan, or x-ray by detecting abnormally small kidneys. Treatment focuses on fluid and electrolyte management to prevent dehydration and correct acidosis.

1. RENAL HYPOPLASIA
Valencia, Danica Mae A.
Rad 3-2
Prof. Bessie C. Tallorin

2. DESCRIPTION
• Congenitally rare anomaly of the kidney that is
developed less than normal in size but contains
normal nephrons
• Results from an embryonic developmental stop
of the kidney
• Usually associated with hyperplasia (condition of
an overdeveloped or greater than the normal
kidney size) of the opposite kidney

3. DESCRIPTION
• Hypoplastic kidney often appears as a miniature
replica of a normal kidney that is functioning
well and has a normal relationship between the
amount of parenchyma and the size of the
collecting system.
• This should be differentiated from an acquired
hypertrophic kidney wherein the kidney is also
small but is contracted because of vascular or
inflammator y disease that has reduced the
volume of renal parenchyma.
• It may be unilateral or bilateral.

4. UNILATERAL HYPOPLASIA
• associated with hypertension in the first decade
of life
Gross photograph of unilateral renal hypoplasia. Note compensatory
hypertrophy of contralateral kidney.
http://www.pathology.vcu.edu/education/PathLab/pages/renalpath/rpsr/i
mages/dev_sr/index.htm

5. UNILATERAL HYPOPLASIA
Occurs with a frequency of one case for
every 500 persons.

6. BILATERAL HYPOPLASIA
• associated with chronic renal failure and
end stage disease during the first decade
of life
SYMPTOMS: Most common are polyuria
(excessive passage of urine) and
polydypsia (excessive thirst)

7. BILATERAL HYPOPLASIA
Gross photograph of Bilateral Renal Hypoplasia
http://www.humpath.com/?bilateral-renal-
hypoplasia&id_document=5705

8. CAUSES
• Unknown and could be connected with
problems in the synthesis of growth factors or
their receptors during the sensitive phase of
metanephrogenesis (fetal kidney)

9. DIAGNOSIS
• X-ray
An x-ray radiograph of a normal vasculature of the small kidney which
demonstrates renal hypoplasia
Mace, J.D. & Kowalczyk (2008). Radiographic Pathology for Technologists , pg. 179

10. DIAGNOSIS
• X-ray
An x-ray radiograph of a hypoplastic kidney with compensatory
hypertrophy
Eisenberg, R.L. & Johnson, N.M. (2007). Comprehensive Radiographic Pathology, pg. 234

11. DIAGNOSIS
• X-ray
X ray manifestations in case 1 at birth with hip dislocation and
bilateral hypoplasia of the ischia and inferior pubic rami
http://jmg.bmj.com/content/37/7/520.full

12. DIAGNOSIS
• CT Scan
CT scan of the abdomen showed left renal hypoplasia and a dilated left ureter
opening probably into the left seminal vesicle, which had a cystic dilation and
calcification within
http://www.actasurologicas.info/v33/n01/ENG/3301NC02.htm

13. DIAGNOSIS
• CT Scan
CT scan of a congenital hypoplastic kidney
http://radiopaedia.org/images/1391705

14. DIAGNOSIS
• ULTRASOUND: A single hypoplastic
kidney may be diagnosed by ultrasound
when a significant discrepancy between
the sizes of the two kidneys is noted.
• The kidney size can also be compared to
normal age-related standards.

15. DIAGNOSIS
•Ultrasound
An ultrasound radiograph demonstrating bilateral renal hypoplasia
Courtesy of Yahoo.com

16. DIAGNOSIS
•Ultrasound
Bilateral cystic renal dysplasia in a 1-day-old girl. US scans of the right (a) and
left (b) kidneys show multiple cysts and echogenic, fibrotic parenchyma. The kidneys
are small for gestational age and retain a reniform shape.
http://radiographics.rsna.org/content/22/6/1429/F17.expansion.html

17. DIAGNOSIS and/or
SYMPTOMS
• When not diagnosed with ultrasound, this is
usually detected during the first few years of
life with symptoms of excessive thirst, a large
urine output, repeated episodes of
dehydration, growth retardation and a failure
to thrive.
• Symptoms may become particularly evident
during minor illnesses such as gastroenteritis.

18. TREATMENT
• THERAPY: by maintaining fluid and
electrolyte (sodium, potassium) balance
and correcting acidosis.
* Blood pressure is usually normal, at
least partially as a result of salt wasting
through the kidney.

19. REFERENCES
• Mace, J.D. & Kowalczyk (2008). Radiographic
Pathology for Technologists , pg. 179
• Eisenberg, R.L. & Johnson, N.M. (2007).
Comprehensive Radiographic Pathology, pg. 234
• http://www.aakp.org/aakp-library/ESRD-in-
Children/
• http://www.embryology.ch/anglais/turinary/pa
tholurinary04.html#hypoplasie
• http://www.obstetricassistant.com/web/ultraso
und.nsf/949df8e79e95cd95ca2577dc0017d18c/8
758cf2c2cc0caf0ca25772f001ad885?OpenDocu
ment