Reflux Pyelovenous

Reflux pyelovenous

Pyellenovenous reflux is a rare pathology in which the postcapillary vessels of the renal parenchyma become permeable. Fluid from the renal tubules and/or diffusion-resorption venules, merging, form refluxing fluid beyond the basement membrane, then flows through previously created channels into the collecting veins and further into the renal vein. There are two types of reflux - obstructive and non-obstructive. With obstructive reflux, the renal veins are full, and blood flows back into the kidneys through the renal sinuses. Depending on the level of obstruction, there are three stages of reflux: the first stage (penile phase), the second stage (fusor phase) and the third stage (recanalization). The obstructive form of reflux is characterized by a gradual deterioration in the outflow of urine and complete obstruction, compensated by the reverse flow of urine. In later stages, associated factors include malignant hypertension, heart failure, portal hypertension, and urinary tract infections. An ascending disturbance of blood flow in the veins, especially the anterior or common renal, leads to compression of the pelvis and prolapse of the ureters. As a result, colliculitis, polyuria, xanthuria, nephrolithiasis, and electrolyte disturbances develop. Diagnosis of venous pyellin reflux is carried out in accordance with specific methods of visualization of the distal region of the nephrocaval junction. CT urography is the test of choice for diagnosing reflux in the pleural veins. Clinical criteria for confirming reflux have low sensitivity and accuracy. Diagnosis can be made by addressing clinical findings, biometrics, and visualization of the veins at the pelvicovascular angle. Also, one of the important indicators is the presence of edema in the circumference of the upper limb above the confluence of the kidneys, which speaks in favor of the vascular nature of the anatomical disorders. The important point is observation, preventive conservative therapy and, if necessary, surgical treatment.