Abstract
Rattner WH, Meyer R, Bernstein J. J Pediatr 1963;63:84-94 This is the fourth of a series of articles that have been the subject of 50 Years Ago pieces in The Journal over the past few years. The first article, “Congenital Abnormalities of the Urinary System: A Post Mortem Survey of Developmental Anomalies and Acquired Congenital Lesions in a Children’s Hospital,”1Rubenstein M. Meyer M. Bernstein J. Congenital abnormalities of the urinary system, I: a postmortem survey of developmental anomalies and acquired congenital lesions in a children’s hospital.J Pediatr. 1961; 58: 356-366Abstract Full Text PDF PubMed Scopus (79) Google Scholar focused on detailed descriptions of these abnormalities, which continue to be important developmental and acquired kidney problems in pediatric patients today. The second article provided the first detailed description of renal cortical and medullary necrosis in neonates,2Bernstein J. Meyer R. Congenital abnormalities of the urinary system, II: renal cortical and medullary necrosis.J Pediatr. 1961; 59: 657-668Abstract Full Text PDF PubMed Scopus (35) Google Scholar and the third provided important normative data on kidney weight and length in children.3Oliver J.T. Rubenstein M. Meyer R. Bernstein J. Congenital abnormalities of the urinary system, III: growth of the kidney in childhood: determination of normal weight.J Pediatr. 1962; 61: 256-261Abstract Full Text PDF PubMed Scopus (6) Google Scholar This article reported postmortem findings in 21 infants with posterior urethral valves and clinical, laboratory, and radiologic findings in 6 infants with posterior urethral valves who survived. The authors reported parenchymal malformations of the kidney in approximately one-half of the infants with posterior urethral valves, and that renal scarring and inflammation were common. The manuscript also describes the role of ureterostomy for diversion of urine until definitive reconstruction can be performed. Many of the infants presented with pyelonephritis and systemic symptoms at several weeks or months of age. Fortunately, today posterior urethral valves are typically discovered much earlier, and are commonly diagnosed during in utero ultrasound examination. In addition, fortunately very few infants die from posterior urethral valves today, as diversion, surgical therapy, and dialysis are implemented when indicated. This article was important in further documenting the common association of obstructive uropathy with renal dysplasia.
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