Shrunken kidneys

Different methods of kidney imaging have shown that Balkan nephropathy patients with chronic renal failure have symmetrically shrunken kidneys with smooth surface and no calcifications [90]. The time at which the shrinking occurs remains to be determined. While some authors suggest that the size of the kidneys remains normal in patients in the latent phase of the disease and with normal renal function, others report cases of shrunken kidneys in patients in an early phase with normal glomerular filtration rate, and it was even proposed that the disease was characterized with primarily small kidneys [98, 110, 112]. As ultrasound became a standard imaging method in the evaluation of kidney dimensions, several recent studies that used this method showed diminished kidney length and cortex width in members of Balkan nephropathy families with normal kidney function [113, 114]. Besides,... 

The most commonly used criteria for the diagnosis of Balkan nephropathy are those proposed by Danilovic et al [99]. They include (1) farmers in the endemic villages, (2) familial history positive for endemic nephropathy, (3) mild proteinuria, (3) low specific gravity of the urine, (4) anemia, early occurrence, normochromic or hypochromic, (5) retention of nitrous compounds in the blood (urea > 50 mg/dl, creatinine > 1.5 mg/dl), (6) symmetrically shrunken kidneys. Using these criteria, Danilovic classified patients into the following groups ... 

Fig.21.2. Doppler sonography. Shrunken, nearly nonper-fused end-stage kidney in an infant with peritoneal dialysis. Peritoneal fluid within Morrison s pouch...

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