There are many congenital problems seen in kidney. Some of them doesn’t warrant any treatment or follow up. There are many harmless tumours occurring in kidneys which also may be ignored. Some pathologies may be kept under surveillance without any intervention if patient is having high risk due to other co morbidities. But occasionally these friends can turn into aggressive foes taking the life of the patient. Few of them are summarized.
A.Poorly functioning kidneys as source of Urinary Tract Infection
A 45 year old lady presented with recurrent urinary tract infection which was treated from different centres. Ultrasonic evaluation showed non-visualised kidney on right side and normally functioning kidney on left. But on further evaluation with CT Urogram showed the right kidney to be smaller in size with poor function. There were few calculi in the ureter. This was the cause of the recurrent infection.
She underwent Right Nephroureterectomy (Right kidney and ureter were removed) and the Urinary infection subsided.
Renal Angiomyolipoma with Haemorrhage
Renal Angiomyolipomas are benign conditions which may not require any treatment. These are benign tumors(not cancerous) with fat content. The chance of these tumours turning cancerous is very rare and does not require surgery for its removal. But some large angiomyolipomas may require intervention. They produce bleeding inside abdomen and produce pain.
This patient was diagnosed to have angiomyolipoma of right Kidney and was on follow up. She later presented with severe abdominal pain and was initially managed conservatively. But later on she developed infection and required Nephrectomy ( Removal of Kidney).
PUJ Obstruction with secondary calculus & Adrenal Myelolipoma
A 55 year old male patient was detected to have right PUJ obstruction with secondary calculus. He has history of cardiac disease for which CABG was done. Considering his cardiac status he was put on surveillance. CT evaluation showed adrenal myelolipoma which was also showing no significant growth on follow up imaging. He had serial Ultrasound evaluations which showed no significant change in status.
After 10 years he was admitted with general weakness and was evaluated. Lab reports showed evidence of gram negative sepsis. He was treated with antibiotics. The source of infection was the hydronephrotic kidney with calculus. He had removal of the kidney along with the adrenal tumour.