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February 1965

Dwarfed Kidneys in Children: The Classification, Etiology, and Significance of Bilateral Small Kidneys in 11 Children

Am J Dis Child. 1965;109(2):130-140. doi:10.1001/archpedi.1965.02090020132008

THE HE RADIOLOGIC demonstration of a single kidney or of bilateral small kidneys in a child presenting with signs and symptoms of renal insufficiency commonly results in the diagnosis of renal hypoplasia. However, small kidneys may be the result of many etiologic factors, including a failure of normal renal differentiation and development, disproportionate growth of the organs, and contraction secondary to scarring.

It is difficult to evaluate and clearly identify which of these factors has operated to produce the small kidneys found in a given clinical problem. Furthermore, the terminology as currently applied to describe these conditions is unsatisfactory. A review of the existing literature, and the classifications and definitions which have been employed are needed.

Bilateral dwarfed kidneys which on microscopic study were normal have not occurred in our experience. The small kidneys which we have studied have invariably shown histologic evidence of either dysplasia or chronic inflammatory disease