12660              CYSTIC AGENESIS OF RIGHT KIDNEY WITH PROLIFERATIVE GLOMERULONEPHRITIS OF LEFT KIDNEY

The patient was a man of 23 known to have right renal agenesis and left pyelonephritis.  He became uraemic and had repeated blood transfusions.  He died with gross generalised oedema.

The specimen consists of the kidneys, renal vessels and portion of the aorta.  The right kidney measures 7 cms in length and consists of a mass of thin-walled cysts with no visible renal substance.  The left kidney is also 7 cms in length.  Its surface shows irregular depressed scars of chronic pyelonephritis.  The cut surface shows marked thinning of the cortex with loss of demarcation between cortex and medulla.  Small irregular yellow flecks are present in the cortex.  The aorta is small and thin-walled.

Histology shows in the left kidney a background of chronic pyelonephritis, but the principal change is advanced proliferative glomerulonephritis.  Surviving glomeruli are greatly swollen and hypercellular, with many adhesions to Bowman’s capsule and some crescent formation.  Some show advanced focal hyaline thickening of glomerular capillary loops.  The right kidney shows fibrous tissue with occasional tubular structures but no glomeruli.