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May 25, 1979

Kidneys With Single Pyramids

Author Affiliations

William Beaumont Hospital Royal Oak, Mich

JAMA. 1979;241(21):2265. doi:10.1001/jama.1979.03290470017014

To the Editor.—  I am sorry that Dr Bischel and her colleagues (240:2467, 1978) have not done a more thorough review of the literature on kidneys with single pyramids. The condition was described specifically by Schubert1 in 1959, and he cited an earlier description. I illustrated this abnormality in a discussion of renal hypoplasia2 and commented on its relationship to oligomeganephronia, a form of congenital renal hypoplasia, with a reduction in the number of lobes and of total nephrons, delineated by Royer and colleagues3 in 1962. The importance of the relationship lies in the frequency with which congenital hypoplasia accounts for chronic renal failure in young people: Approximately 10% of end-stage renal disease in children can be attributed to oligonephronic hypoplasia,4 the proportion being considerably lower in adults because the mortality of oligonephronic hypoplasia lies principally in childhood and because other causes of renal failure increase