My baby has right obstructive uropathy with enlarged kidney. What is the treatment?

Question

Hello doctor,

My baby is 2 years 8 months old. His right kidney is enlarged with poor and delayed functioning. I tested DTPA and IVU. It was seen that the left kidney is functioning and the right kidney has obstructive uropathy. My doctor said to get an operation to remove the block in the right Kidney. But my baby has no symptoms, illness. He is totally fine and normal. He is a little baby, What can I do? Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I have seen the reports. (attachment removed to protect patient identitiy). The reports indicate that there was some obstructive uropathy in the right side, that has been corrected. But the DTPA (diethylene triamine penta acetic acid) shows almost equal function of both kidneys, it means functionally the right kidney is also equal to the left. IVU (intra venous renogram) shows obstructive uropathy that has been corrected. The delayed excretion is due to obstruction. For functional status, we see DTPA and not IVU. The second one is for the localization of the obstruction or anatomical abnormalities. So the conclusion is, the scan indicates that functionally both kidneys are equal. We need to do renal function test, blood, urea and creatinine that measures the total function of both the kidneys. The report of the same was not available, I think it must have done and must have reported you if abnormal, I am sure that is normal.

Now let us short discussion regarding this case. This obstructive uropathy causes the derangement of kidney function due to pressure effect, this depends on the duration of the abnormality. If damage has occurred that is unlikely to revert back to normal. But further damage can be prevented by an early intervention that has been done in your case. You must remember that some of the normal population is having single kidney with normal life span and life style, many of them not detected during their lifetime. My purpose of this is that it is fine with a single kidney also. Plan for your case, monitor renal function test every three months if normal or more frequently if abnormal, monitor growth (height, weight) and other nutritional deficits and get them corrected, monitor blood pressure once in a month if normal, monitor DTPA and DMSA (dimercaptosuccinic acid) six-monthly, keep in touch with your doctor as per his advice, and get vaccination against preventable diseases. I am sure that your child will be fine if you follow adequately. Review as per your requirement.