Effect of chronic, low-pressure, sterile vesicoureteral reflux on renal growth and function in a porcine model: A radiologic and pathologic study

H. J. Paltiel, R. V. Mulkern, A. Perez-Atayde, L. P. Connolly, D. Zurakowski, S. Ted Treves, A. Atala

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

PURPOSE: To study the effects of chronic, low-pressure, sterile vesicoureteral reflux (VUR) on renal growth and function in a porcine model. MATERIALS AND METHODS: Unilateral VUR was created in five pigs, with the contralateral kidney serving as a control. Preoperatively, and 1 year later, ultrasonography, technetium 99m-dimercaptosuccinic acid (DMSA) scintigraphy, contrast material-enhanced computed tomography (CT), and contrast-enhanced magnetic resonance (MR) imaging were performed. Morphologic abnormalities and relative uptake of 99mTc-DMSA were recorded. The postcontrast enhancement ratios for parenchymal regions of interest at CT and MR imaging were determined. Ruthenium 103-labeled microspheres were used to determine regional blood flow. After the pigs were sacrificed, the kidneys were excised, weighed, and analyzed pathologically. RESULTS: Two of five refluxing kidneys had less than 45% function at scintigraphy. One of these two kidneys was small at postmortem examination. There were no other imaging or gross pathologic abnormalities. There was no significant difference in regional blood flow between the refluxing and nonrefluxing kidneys. In all of the operated on kidneys, histologic examination showed focal chronic inflammation and fibrosis. CONCLUSION: Low-pressure sterile reflux into previously normal kidneys led to mild, focal, chronic interstitial inflammation and fibrosis after 1 year. Imaging findings were normal apart from a subtle decrease in tubular function in two refluxing kidneys.

Original languageEnglish (US)
Pages (from-to)507-515
Number of pages9
JournalRadiology
Volume217
Issue number2
DOIs
StatePublished - Jan 1 2000

Keywords

  • Animals
  • Kidney, CT
  • Kidney, function
  • Kidney, MR
  • Kidney, perfusion
  • Kidney, radionuclide studies
  • Kidney, US
  • Ureter, reflux
  • Voiding cystourethrography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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    Paltiel, H. J., Mulkern, R. V., Perez-Atayde, A., Connolly, L. P., Zurakowski, D., Ted Treves, S., & Atala, A. (2000). Effect of chronic, low-pressure, sterile vesicoureteral reflux on renal growth and function in a porcine model: A radiologic and pathologic study. Radiology, 217(2), 507-515. https://doi.org/10.1148/radiology.217.2.r00nv18507