By hyperplasia means the formation of an excessive amount of structural elements of any tissue or organ. This process can be as natural - the increase in the mammary glands during pregnancy, for example, occurs due to active reproduction of the epithelial cell, but it can also be pathogenic - the development of tumors. With kidney hyperplasia, not everything is so unambiguous.
Hyperplasia of the kidney
Hyperplasia must be distinguished from hypertrophy. In the second case, the size of the cells increases, while in hyperplasia, as a rule, tissue growth is observed. The newly formed cells have completely correct structure, are healthy, functional and possess the correct chromosomal set.
There is a possibility of degeneration of advanced hyperplasia into malignant formation. This danger is the main reason for the observation and regulation of hyperplasia.
The deviation activation mechanism is unclear. However, it is known that most of this kind of ailments occurs against the backdrop of insufficient work of the body itself. So, kidney hyperplasia is very often observed in cases when one of the organs is removed or malofunctional due to inflammation or other damage. In this case, the hyperplastic process acts as a kind of compensating mechanism, which allows to restore the functionality of the organ.
However, the enhanced development of renal tissue can occur for other reasons related to endocrine disorders, malfunctions in the hormonal system, and so on. In this case, an increase in the body and excessive functionality of it disrupts the entire body. After all, growing kidney tissue requires nutrition and oxygen, that is, improving blood circulation. In addition, the excessive activity of excretory function is also not a positive factor.
This ailment is not common. Often, it is found by chance during a preventive examination, because no symptoms are accompanied. When detected, it is important to establish how much the growth of new tissue has a strong effect. If the new cells are healthy and functional, the excretory function is normal and the patient feels well, no treatment is required. However, to observe an enlarged kidney is necessary.
Hyperplasia in children is much less common and, as a rule, has a different character. Most often, hypertrophy of the right kidney and leftotrophy are established. And such a situation is considered dangerous, since it can lead to hyper development of one paired organ in a child against a background of dysfunction or failure of the second. In this case, treatment is necessary.
In newborns, the disease is not documented. Unlike hypoplasia, hyperplasia is not inherent in nature.
The code for MBK 10 is as follows: kidney dysplasia is Q61.4, and the hyperplastic and giant kidney is Q63.3.
Pathogenesis and causes of
According to studies, the growth and division of cells in hypertrophied tissue occurs by a natural mechanism: by direct and indirect division. As a rule, not only an increase in the number of cells is observed, but also the growth of cytoplasmic structures - mitochondria, ribosomes.
Hyperplastic processes can occur almost in any tissue. In fact, the regeneration of the circulatory system after heavy blood loss or the restoration of tissue after its damage due to trauma or infection - all this refers to hyperplasia.
Considers several theories that explain the activation of the hyperplastic process:
- Most often, kidney hyperplasia is observed after severe organ infections - glomerulonephritis, pyelonephritis and so on. It wears an obvious compensatory character and helps restore the functionality of the organ.
- The same role is played by the removal of one kidney or its low functionality. In a healthy kidney, about 60% of nephrons are constantly in working order. With the loss of one of the organs in the second, up to 95% become active. The kidney increases in size, the lumen of the tubules widens, the renal glomeruli increase in size. In this case, hyperplasia is also a compensating mechanism.
- However, the cause of hypertrophic development may be a neurogenic pathology or disorders in the endocrine system. At the same time, excessive production of certain hormones affects the kidney structures, stimulating excess fission. And the excessive activity of an organ adversely affects the condition of others.
Forms and types of
The process is classified according to the role that it performs in the body. Allocate the following forms.
Working - develops as a result of increasing the load on the organ. There is a need for this not only when one of the kidneys refuses to function, but also in those cases when the total load on the body for one reason or another increases.
Dyshormonal - a form that occurs when there are abnormalities in the hormonal system. It is caused by pathological processes or by the administration of certain drugs.
The vicar - or substitute. This is just the option when an increase in a single kidney compensates for the absence of a right or left kidney.
The vicar is divided into 2 subspecies:
- is real - that is, the kidney tissue grows, which leads to compensation for the absence of the second organ;
- false - connective tissue or adipose tissue grows. This process is pathological and leads to disruption of the kidney and urinary system. In fact, this option is subject to treatment.
Hyperplasia has no age limitations and can be observed in both young people and patients in the older age group. The real vicum form is more often and more quickly manifested in young, more healthy patients.
Symptoms of
In the vast majority of cases, hyperplasia does not manifest itself. The exception is false, since in this case the proliferating tissue to the kidneys has nothing to do and, on the contrary, suppresses the activity of nephrons.
The symptoms of the ailment include:
- an increase in the size of the body - is detected on examination;
- increase in renal structures - also detected only by a diagnostic method;
- pain in the lumbar region. Pain from the working organ can be projected onto the entire lower back. This symptom occurs, as a rule, with a false vicar form, since it indicates abnormalities in the functioning of the organ.
There may be atypical symptoms like elevated temperature, increased blood pressure, general discomfort.
Diagnosis
Because of completely uncommon symptoms, it is not possible to diagnose hyperplasia during routine examination or based on patient complaints. Establish a deviation only after examinations.
Assign the following assays:
- General analysis - allows you to set the pH of urine and the presence or absence of protein. In fact, this is a preliminary analysis, indicating the presence of dangerous deviations.
- The level of creatinine in the blood - allows you to judge the rate of glomerular filtration. If the latter is normal - not less than 90 ml per minute, false hyperplasia disappears.
- The level of blood glucose allows you to obtain indirect data on the state of blood vessels.
- A study for urea nitrogen in the blood - thus establish the quality of glomerular filtration.
- Ultrasound is the most accessible and simple method. With its help determine the size of the organs, the general condition and condition of the circulatory system that serves the kidneys. For the same purpose, an MRI can be assigned.
- Biopsy - conducted to exclude malignant diseases.
Treatment of
Hyperplasia in adults is, in most cases, a normal process that compensates for the inadequate functioning of the second kidney or its absence, as well as the response to increased stress. It can not be treated, but it is still necessary to observe the development of the tissue.
- False hyperplasia requires intervention. However, treatment depends on the patient's condition and history.
- The same goes for the dyshormonal form. Here, all efforts are made to normalize the hormonal background, since the proliferation of kidney tissue is only a consequence.
Children are treated with a combination of hypertrophy and kidney malnutrition.
Prevention and predictions of
The best prevention to prevent a process is to prevent the condition when one of the kidneys fails, and the second is forced to work with a doubled load. For this, it is necessary to observe some restrictions in the diet - there is no salt, spicy dishes, smoked foods, and, of course, in the regime of the day - sufficient rest, motor activity, stay in the fresh air.
The prognosis for setting such a diagnosis is favorable. However, this concerns only the real vicar and working form. Dyshormonal and false need a course of therapy.
Renal hyperplasia in most cases is a natural reaction to the dysfunction of one of the kidneys. As a rule, the development and growth of