Renal ptosis. Results of a national survey

BACKGROUND: Renal ptosis is the caudal acquired displacement of one or both of the kidneys, with different degree and etiology, considered as a urological pathology because of its urodynamic changes and, in the last years, almost completely neglected. METHODS: The aim of the work is to research a parenchymal involvement, through a close examination of our outpatient's record; compared with data from the literature on renal ptosis and with the results of a national questionnaire to specialists. RESULTS: The literature reports a largest incidence in females; in our cases, instead, the incidence is nearly the same. The 2nd degree ptosis is the most frequent, but, in females, bilateral ptosis is prevalent (77%). We agree with the literature about urinary symptoms; actually, the most of the patients shows urinary colics or lumbar pain. We also noticed UTI (62%), urinary lithiasis (26%) and pyelocalyceal ectasia (46%). A lot of patients suffer from microscopic hematuria (77%) and, in 12%, gross haematuria was noticed. Hypertension affects about an half of the patients (46%) and the proteinuria too (42%). Echography highlights a reduced cortex (12%), cysts (14%) and other changes (8%). GFR is decreased in 30% of cases, in different degree. The patients show different changes, according to their age. The results of the national questionnaire are also reported. CONCLUSIONS: In conclusion, considering the remarkable incidence and anatomical and functional changes, it is suggested to consider renal ptosis as a cause of chronic renal damage, also because it is included among the causes of obstructive nephropathy, which according to some researchers, can cause severe glomerular and tubular-interstitial changes, triggered off by a short urinary stasis and evident in the contralateral kidney too.