The Pathogenesis of Polycystic Kidneys: Reconstruction of Cystic Elements in Four Cases

Publisher Website
Google Scholar
Abstract
The important theories of origin of polycystic kidneys were reviewed. From serial sections, several collecting ducts and cysts in the kidneys of each of 4 cases were reconstructed to scale in drawings. For a long period in fetal life development of the kidneys was normal. Focal cystic dilatations of uriniferous tubules and collecting ducts occurring after differentiation of the metanephrogenic anlage and after the union of its elements with collecting ducts was followed by isolation as cysts of segments of these nephrons. Anastomoses among these cysts resulted from continued proliferation of these elements and from rupture of their walls. These changes were possibly degenerative since they resembled the stages in the normal degeneration of the mesonephros and of normally vestigial elements of the metanephros. In the case of poly cystic kidneys, therefore, to a variable degree the metanephros is abnormally provisional. Such an explanation is applicable to most of the congenital anomalies associated with polycystic kidneys and is compatible with the hereditary nature of the disease. The fundamental cause of polycystic disease of the kidneys must be in the germ plasm.