Small kidney

In a study with female mice exposed orally in feed to uranyl nitrate hexahydrate at a dosage of 462 mg U/kg/day for 36 44 weeks, average uranium accumulation was 6 pg per pair of kidneys, 46 pg/g bone and 0-0.5 pg in whole liver, respectively. No significant organ accumulation was found for the lower dose levels (Taimenbaum and Silverstone 1951). Maximal concentrations of 77 pg per pair of kidneys and 216 pg/g in bone were estimated at 50 weeks in male mice that were orally exposed to uranyl nitrate hexahydrate at 925 mg U/kg/day for 48 weeks. One mouse with small kidneys showed levels of 395 pg/pair of kidneys and 1,440 pg/g bone (Taimenbaum and Silverstone 1951). Average uranium accumulation in the kidneys and bone of male mice exposed to uranyl fluoride orally at 452 mg U/kg/day for 28 weeks was 33 pg/pair of kidneys and 145 pg/g bone at 20 weeks (Tannenbaum and Silverstone 1951). Maximal concentrations of 6 pg/pair of kidneys at 50 weeks and 29 pg/g bone at 14 weeks were found in female mice given oral uranium tetrachloride at 978 mg U/kg/day for 48 weeks (Tannenbaum and Silverstone 1951). 

Clinical evidence suggestive of analgesic nephropathy includes nocturia, renal insufficiency with severe acidosis, persistent urinary tract infection with colic, hematuria, and hypertension (40,41). Nocturia resulting from failure to concentrate urine is usually the earliest functional defect, but like the other symptoms it is non-specific, rendering the diagnosis of analgesic nephropathy difficult. A CT scan showing bilateral small kidneys with bumpy contours, and papillary calcification is accepted to be of sufficient specificity (38,39). 

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,... 

Fig. 4 IVP showing small kidneys with loss of parenchyma. 

In a previous study, although numbers were small, kidney and spleen cancers were detected in two of the eight untreated control OLETF rats, but in none of the eight thiamine-treated rats. Thiamine deficiency may predispose individuals to neoplastic conditions. Thus, excess carbohydrate intake may be accompanied by a relative thiamine deficiency and may become a risk factor for cancer. 

Polito C, La Manna A, Rambaldi PF, Nappi B, Mansi L, Di Toro R (2000) High incidence of a generally small kidney and primary vesicoureteral reflux. J Urol 164 479-482... 

Bengtsson C, Hood B (1971) The unilateral small kidney with special reference to the hypolplastic kidney. Review of literature and authors point of view. Int Urol Nephrol... 

Renal involvement ranges from near-normal kidneys to a severe degree of dysplasia with primitive ducts in embryonic mesoderm, cysts, and metaplastic cartilage. Severe renal dysplasia may resemble type II cystic kidneys according to Potter (1972), but also small kidneys with subcortical glomerular and tubular cysts as a consequence of urethral obstruction have been reported, as seen in type IV cystic dysplasia. 

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