Caso 8-Embriología-Grupo 01 Renal

 

 

Msigomturm kn Nlcrihdhgìm II

NLCSIHDHGIM II IV @i`dh kn Nstukihs Pnlnstrn M`mkéli`h 3131-II @MPH @DÌOI@H VIII Muthrns  ‐  GS^QH  GS^QH 1=    Mdtmlirmoh Mdtmlirmoh Omo`y Omo`y Mrm`ndy

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   Mr`n Ns`hcnkh Mdissho Dumom

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  Cnromd Ikrhgh Pmokrm Dissnt

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  @mjushd Pu`dupn Vi`thr Eugh

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  @hrkhvm Lhdiom @ristimo Grnghrih   @emvnz Qms`h Gmukey Pujeny

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  Kndgmkh Crn`im, Fdmvih Fmcrizzih

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  Kuírnz Snyns Snozh Mokrné

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  Ndnrm Smlirnz Mogin Penydny

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  Gmvikim Omvmrrh Guissndm Jukite

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  Eumlío Enrnkim Lmrìm Endizmcnte

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  Lhdh`eh Kimz Kmdim Cnrnois

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Kh`notn  Kr. @mdknrðo Vid`enz Qnr`y Mdcnrth  

@ei`dmyh  ‐  Qnrú  Qnrú

313=-1 

 

  =.  Lnohr kn 3 mýhs ns ddnvmkh m `hosudtm léki`m phr dm lmkrn quino rnfinrn qun em prnsnotmkh mdzm térli`m `umotifi`mkm 09±`, nd lnki`h dungh kn dm nvmdum`iðo ioki`m nxílnons dmchrmthrimdns2 knotrh kn dhs `umdns dh úoi`h phsitivh ns nd nxmlno kn hriom pmthdðgi`h: +=11 dnu`h`iths phr `mlph. Pinokh lnki`mkh `ho moticihti`htnrmpim sngúo nd `udtivh kn hriom y moticihgrmlm2 dm lmkrn rnthrom m dm `hosudtm léki`m m dms 3 snlmoms siguinotns knd térlioh knd trmtmlinoth mku`inokh oh lnjhrìm `dìoi`m, nd léki`h trmtmotn ioki`m uo ounvh nxmlno kn hriom qun mrrhjm dnu`h`iths +=11 phr `mlph2 ioki`mokh uo nxmlno kn ilígnons: khokn sn nvikno`im eikrhonfrhsis, uom kidmtm`iðo kn urétnrns. @hlh motn`nknotns pmthdðgi`hs: nd enrlmoh lmyhr knd pm`inotn no lno`iðo sufrn kn Snfdujh vnsi`hurntnrmd.

M.  Ilprnsiðo kimgohsti`m Snfdujh Vnsi`hurntnrmd Pn knfion `hlh nd pmsh rntrðgrmkh oh fisihdðgi`h kn dm hriom knskn dm vnjigm md urétnr. Pn knohliom SV^ sn`uokmrih md qun nstí h`msihomkh phr uom `dmrm `musm pmthgéoi`m, `hlh h`urrn no dhs prh`nshs hcstru`tivhs urntrmdns kn `musm momtðli`m (vídvudms kn urntrm phstnrihr) h fuo`ihomd (vnjigm onurðgnom). Pn knohliom SV^ prilmrih `umokh oh nxistn uom `musm nviknotn y sn suphon qun ns kncikh m uo knfn`th, cino momtðli`h h fuo`ihomd, kn dm prhpim uoiðo urntnrhvnsi`md. No nstn prhth`hdh ohs rnfnrirnlhs nx`dusivmlnotn md SV^ prilmrih. Dm `dmsifi`m`iðo SV^mdsnurétnr fuokmlnotm no dm nstrmtifi`m`iðo nstr mtifi`m`iðo lmgoitukmomtðli`m knd pmsh rntrðgrmkh kn dm hriom kn dmknd vnjigm y kn dm `mpm`ikmk kn mdtnrmrkn dm dmnstru`turm kn dm vìm uriomrim. Dm `dmsifi`m`iðo lís m`nptmkm ns dm nstmcdn`ikm phr nd Iotnromtihomd Snfdux Ptuky @hllittnn no nd oiýh. Pngúo nstm `dmsifi`m`iðo, sn nstmcdn`no `io`h grmkhs kn rnfdujh. No gnonrmd, sn m`nptm qun dhs SV^ grmkhs I y II sho dnvns2 nd grmkh III ns lhknrmkh, y dhs grmkhs IV y V sho grmvns. Dm ilphrtmo`im `dìoi`m knd SV^ no dhs oiýhs em vnoikh kntnrliomkm phr su msh`im`iðo `ho dm  prnsno`im kn iofn``ihons uriomrims kn rnpnti`iðo y nd phsicdn nstmcdn`ilinoth kn uo kmýh rnomd `rðoi`h qun `hokuz`m m dm prhgrnsiðo m iosufi`ino`im rnomd. Dms lmdfhrlm`ihons rnomdns, y notrn nddms nd SV^, siguno sinokh dm prio`ipmd `musm kn NS@ no nd oiýh. Qhr tmoth, nd lmonjh `uikmkhsh kn nsths pm`inotns m dmrgh pdmzh ns uom pinzm `dmvn no phdìti`ms kn prnvno`iðo kn dm iosufi`ino`im rnomd tnrliomd. Dm mpmri`iðo knd Snfdujh Vnsi`hurntnrmd sn kncn m uom mohlmdìm lmkurmtivm knd ln`moislh vmdvudmr kn dm uoiðo urntnrhvnsi`md. Dm ynlm urntnrmd ns dm rnsphosmcdn knd knsmrrhddh knd urétnr. Pi nd hrigno kn dm ynlm urntnrmd h`urrn luy `nr`m kn dh qun snrí dm futurm vnjigm, nd hrifi`ih urntnrmd nstmrí knspdmzmkh dmtnrmdlnotn, kmokh dugmr m qun nd túond suclu`hsh knd urétnr no dm vnjigm snm lís `hrth, fm`iditmokh dm mpmri`iðo knd SV^. Ki`eh túond sn mdmrgm `ho dm nkmk, dh

 

qun mulnotm dm `hlpntno`im knd ln`moislh vmdvudmr y prhku`n dm rnshdu`iðo nsphotíonm knd SV^ no dm lmyhrìm kn dhs oiýhs kurmotn nd pnrihkh kn `rn`ilinoth. [mlciéo pmrn`no nxistir htrhs fm`thrns kifnrnotns m dm mfn`tm`iðo knd ln`moislh vmdvudmr, `hlh dm prnsno`im kn uom kisfuo`iðo vnsi`md h uo sìokrhln kn ndiliom`iðo kisfuo`ihomd, qun punkno tnonr uo pmpnd ilphrtmotn no dm pmthgnoim knd SV^, phr dh qun ns ilphrtmotn em`nr uom vmdhrm`iðo kn dm fuo`iðo vnsi`md. Qhr htrm pmrtn, no pm`inotns `ho SV^ punkn nxistir kmýh rnomd msh`imkh, knohliomkh onfrhpmtìm knd rnfdujh (OS) h onfrhpmtìm `i`mtri`imd (O@), y qun punkn tnonr uo hrigno `hogéoith h mkquirikh. Dm prnvmdno`im knd SV^ pmrm nd `hojuoth kn pnrshoms no nkmk pnkiítri`m m oivnd oi vnd phcdm`ihomd sn nstilm qun ns kn notrn uo = y uo 0%. No pm`inotns kimgohsti`mkhs kn eikrhonfrhsis prnomtmd (EOQ), dm prnvmdno`im kn SV^ ns knd =6% kn dhs `mshs. No pm`inotns kimgohsti`mkhs kn I[^ dm  prnvmdno`im kn SV^ hs`idm notrn n otrn uo =5 y uo 05%. No `umoth m dm io`ikno`im fmlidimr, nd SV^ sn no`unotrm no nd 37% kn dhs enrlmohs y no nd 0>,7% kn dhs eijhs kn dhs pm`inotns `ho SV^. No gnlndhs lhoh`ighths, dm prnvmdno`im knd SV^ ns knd k nd =11, y knd >1% no gnlndhs ki`ighths. Dm prnvmdno`im knd SV^ vm kisliouynokh `ho dm nkmk knd oiýh, `ho uom tmsm kn rnshdu`iðo nsphotíonm knd =1-=>% phr mýh, m dh dmrgh knd `rn`ilinoth. (=) C.  Nxpdiqun nd ln`moislh nlcrihdðgi`h kn dm notikmk Dm onfrhpmtìm qun sn msh`im md SV^ sn kncn m uo ln`moislh `hlúo qun mfn`tm md lislh tinlph no nd knsmrrhddh nlcrihdðgi`h knd sistnlm uriomrih y rnomd. Qmrm notnoknr dm msh`im`iðo kn SV^ y lmdfhrlm`ihons rnomdns ns prn`ish `hlprnoknr nd knsmrrhddh knd trm`th uriomrih y knd riýðo. No dhs vnrtncrmkhs, nd riýðo prh`nkn kn dhs `hoku`ths lnshoéfri`hs, uom pmrnjm kn `hrkhons npitndimdns qun sn nxtinokno m dh dmrgh knd njn motnrh-phstnrihr knd nlcriðo. Dm ynlm urntrmd (Y^) sn nxtinokn knskn nd `hoku`th lnshoéfri`h sucinokh emstm nd cdmstnlm rnomd. No dm ;ª snlmom knd knsmrrhddh nlcrihomrih, snýmdns rn`ìprh`ms notrn dm Y^ y nd cdmstnlm lntmoéfri`h mkym`notn, ioku`no qun nd nxtrnlh kistmd kn dm Y^ `hlino`n m cifur`mrsn y m fhrlmr dhs `hoku`ths `hdn`thrns. Md lislh tinlph nd cdmstnlm lntmoéfri`h sn npitndizm fhrlmokh dms onfrhoms. Nd nxtrnlh prhxilmd kn dm Y^ pnrlmon`n uoikh md `hoku`th lnshoéfri`h y fhrlmrí nd urétnr kistmd. Nd `hoku`th oéfri`h `hlúo, qun ns nd snglnoth knd `hoku`th lnshoéfri`h qun nodmzm nd urétnr y nd snoh urhgnoitmd (prilitivm vnjigm), nstí prhgrmlmkh pmrm dm lunrtn `ndudmr, dh `umd pnrlitn md urétnr iosnrtmrsn knotrh kn dm vnjigm (trmyn`th suclu`hsh) y knsmrrhddmr uom `mpm lus`udmr qun `hon`tm `ho nd trìghoh vnsi`md. (3) 

 

 Oulnrhshs nstukihs emcdmo kn qun dm phsi`iðo kn dm Y^ no nd `hoku`th lnshoéfri`h ns fuokmlnotmd pmrm nd knsmrrhddh knd riýðo y nd trm`th uriomrih. Kn nstn lhkh uom Y^ situmkm knlmsimkh `rmonmd rnsudtmrìm no uo hrifi`ih situmkh no dm urntrm h no nstru`turms gnoitmdns2 linotrms qun dm phsi`iðo ioi`imd kn dm Y^ knlmsimkh `mukmd ddnvmrìm m uom iosnr`iðo no nd trìghoh tr ìghoh knlmsimkh `rmonmd y `hlh `hosn`uno`im uom uoiðo urntnrhvnsi`md `hrtm h dmtnrmd md trìghoh. Jm`bin y Ptnpenos (36) nxmliomrho dm`tmotns phstlhrtnl mfn`ths kn kupdi`ikmk rnomd y emddmrh emddmrhoo qun dm phsi`iðo knd hrifi`ih urntrmd sn `hrrndm`ihomcm `ho dm lhrfhdhgìm rnomd kn tmd lhkh qun rnsudtmcm uo riýðo kispdísi`h no `msh kn phsi`iðo knd hrifi`ih h rifi`ih dmtnrmd md trìghoh h no dm urntrm. (3) ( 3)

Dms lmdfhrlm`ihons `hogéoitms knd riýðo y knd trm`th uriomrih, knohliomkms tmlciéo `hlh @MB^[ (knd m`rhoilith iogdés @hognoitmd Mohlmdins hf ten Bikony mok ^riomry [rm`t) rnprnsnotmo uo mlpdih nspn`trh kn mdtnrm`ihons knd knsmrrhddh nlcrihomrih knd sistnlm `hdn`thr, knd pmréoquilm rnomd h kn dm ligrm`iðo kn luy kifnrnotn prhoðsti`h. Muoqun dm lmyhrìm sho msiothlíti`ms n io`dush trmosithrims, su ilphrtmo`im rmki`m no snr dm prio`ipmd `musm kn Nofnrlnkmk Snomd @rðoi`m oh tnrliomd (nstmkihs II-IV, >5%) y tnrliomd (;1->1%) no dm nkmk  pnkiítri`m. Qhr htrm pmrtn, suphono uo =>-31% kn dms mohlmdìms kntn`tmkms no dms n`hgrmfìms  prnomtmdns, mfn`tmokh md 1,0-=,0‱ kn dhs rn`iéo om`ikhs. Pn msh`imo lmdfhrlm`ihons nxtrmrrnomdns no uo 01%. (0)  @.  Fm`thrns kn rinsgh Dhs siguinotns fm`thrns mulnotmo dm phsicidikmk kn qun nd oiýh rnfdujh vnsi`hurntrmd: Kisfuo`iðo kn dm vnjigm y nd iotnstioh: Dhs oiýhs qun pmkn`no KNCK tinokno m rntnonr su hriom y en`ns, tmlciéo frn`unotnlnotn  pmkn`no I[^ y nsth punkn punkn gnonrmr nd rnfdujh vns vnsi`hurntrmd. i`hurntrmd. (;) Smzm: Dhs oiýhs `mu`ísi`hs (cdmo`hs) tinono uom lmyhr prnkisphsi`iðo m pmkn`nr rnfdujh vnsi`hurntrmd. (;) Pnxh: Dms lujnrns tinono lmyhr prnkisphsi`iðo m knsmrrhddmr rnfdujh vnsi`hurntrmd, oh hcstmotn, nd rnfdujh vnsi`hurntrmd qun nstí prnsnotn md om`nr ns lu`eh lís `hlúo no vmrhons. (;) Nkmk: Pn no`unotrmo lís prhpnoshs m tnonr rnfdujh vnsi`hurntrmd dhs cncés y oiýhs kn emstm 3 mýhs. (;) Motn`nknotns fmlidimrns:

 

[inokn m snr uo rmsgh kn fmlidim. Ns lís `hlúo qun sn pmknz`m si dhs pmkrns tuvinrho rnfdujh vnsi`hurntrmd, msì `hlh dhs enrlmohs kn dhs oiýhs qun dh pmkn`no tmlciéo `hrrno nd rinsgh kn tnonrdh y no nstn `msh sn rn`hlinokm r n`hlinokm dm rnmdizm`iðo kn nxílnons kn kntn``iðo k ntn``iðo pmrm nstm mfn``iðo. (;) Knfn`ths kn om`ilinoth: [mdns `hlh nspiom cìfikm y knfn`ths qun mfn`tno md trm`th uriomrih. (>) K.  Emgm uo lmpm `ho`nptumd knd siguinotn mrti`udh lnki`h: ettp://s`indh.sdk.`u/s`indh.pep8s`ript snlmoms kn gnstm`iðo, dhs riýhons lnshoéfri`hs kmo dugmr m uom pnquným `motikmk kn hriom luy kiduikm, pnrh nd lnshonfrhs kngnonrm m fiomdns knd tnr`nr lns, `umokh dhs riýhons lntmoéfri`hs emo mkhptmkh ym su fhrlm. Dhs túcudhs knd riýðo lntmoéfri`h nlpinzmo m fuo`ihomr notrn dms snlmoms 9 y =3, y sus fuo`ihons kn rnmcshr`iðo sn prhku`no no nd msm kn Enodn em`im dm snlmom =;, muoqun sn sigmo fhrlmokh onfrhoms ounvms emstm nd om`ilinoth. Dm hriom prhku`ikm phr nd riýðo fntmd ns eiphtðoi`m rnspn`th md pdmslm kurmotn dm lmyhr lm yhr pmrtn kn dm gnstm`iðo, dh qun rnfdnjm ln`moislh kn rnmcshr`iðo iolmkurhs, qun sn phono kn lmoifinsth lhrfhdðgi`mlnotn phr dm  prnsno`im kn msms kn Enodn `hrtms. @hofhrln nd dðcudh onurmd kn dm eipðfisis `hlinozm m  prhku`ir ehrlhom motikiuréti`m no dm snlmom ==, nlpinzm m nstmcdn`nrsn htrh ln`moislh kn `ho`notrm`iðo uriomrim. (=6, =7)

 

N.  Dnm nd siguinotn mrti`udh y emgm uo lmpm `ho`nptumd: ettps://www.mnpnk.ns/sitns/knfmudt/fidns/momdns/;6->-=0.pkf  

 

SNFNSNO@IMP CICDIHGSÍFI@MP: =.  Ns`ricmoh Pucìms J, Vmdno`imoh Funotns C. SNFD^JH VNPI@H^SN[NSMD RIotnront\. Mnpnk.ns. 31=; R`itmkh nd 01 kn h`tucrn knd 3131\. Kisphoicdn no: ettps://www.mnpnk.ns ettps://www.mnpnk.ns/sitns/knfmudt/fidns/kh`ulnoths/=7Xrnfdu /sitns/knfmudt/fidns/kh`ulnoths/=7XrnfdujhXvnsi`hurntnrmdX1.pkf  jhXvnsi`hurntnrmdX1.pkf  

3.  Lhrmdns M, @mdvh S, @emffmond L. Nlcrihdhgìm y gnoéti`m knd rnfdujh vnsi`hurntnrmd prilmrih y kn dm kispdmsim rnomd msh`imkm. Nsp urhd. 3115. vhd. 6=(3). Qíg. ==7-=31 

0.  Shlnrh F. Mohlmdìms `hogéoitms knd riýðo y knd trm`th uriomrih. ^oikmk kn onfrhdhgìm. R@hosudtmkh

nd

01

kn

h`t.

knd

3131\.

Kisphoicdn

no:

ettp://spmpnx.ns/sitns/knfmudt/fidns/fhrhXpnkimtri`hX31=9X0.pkf  

;.  Lmyh @dioi`. Snfdujh vnsi`hurntnrmd RIotnront\. Nstmkhs ^oikhs2 `3131 R@itmkh nd 01 kn h`tucrn kn 3131\. Kisphoicdn no:  no: ettps://www.lmyh`dioi`.hrg/ns-ns/kisnmsns-`hokitihos/vnsi`hurntnrmdrnfdux/sylpthls-`musns/sy`-310755=9 

>.  Dyhos P, Ptmed S, Jhons Q. Snfdujh vnsi`hurntnrmd RIotnront\. Nstmkhs ^oikhs2 RÚdtilm rnvisiðo Nonrh 31=>\ R@itmkh nd 01 kn h`tucrn kn 3131\. Kisphoicdn no: ettp://stjhsnpenurnbm.lye ettp://stjhsnpenurnbm.lyehspitmdwncsitn.`hl/mpps/Enm hspitmdwncsitn.`hl/mpps/EnmdteGmtn/Mrti`dn.mspx8`euobi dteGmtn/Mrti`dn.mspx8`euobiik;0 ik;0   6.  Vísqunz-Gumrìo @, Shjh-Ghozídnz F, Sìhs-Pmdmzmr J, Suiz-Omrmojh B, Pmrlinoth-Shkrìgunz J@, Vísqunz-Gumrìo @, nt md. Siýðo no enrrmkurm. Snvistm @hdhlcimom kn Onfrhdhgìm. ki`inlcrn kn 31=72;(3):3=7-3>. 7.   Omtsis B, Qimgbhu L, Pbhtsilmrm M, Qrhthgnrhu V, [sithurikis I, Pbmokmdmbis Q. Ehrsns Ehrsnsehn ehn bikony: m rnvinw hf momthly mok pmtehdhgy. Purg Smkihd Momt. = kn mghsth kn 31=;206(6):>=73 1=;206(6):>=7-

36. 5.  Chumdi H, Dmcmrrn K, Lhdioinr F, Dhpnz S, Cnohumi`e V, Dmuwnrs F, nt md. Momthli` vmrimtihos hf ten rnomd vnssnds: fh`us ho ten prn`mvmd riget rnomd mrtnry. Purg Smkihd Momt. = kn judih kn 31=320;(>):;;=-6. 9.  Pmbmdm LK, Kynr SC. [en ehrsnsehn bikony. Mckhl Ilmgiog. = kn h`tucrn kn 31=>2;1(7):39=1-=. =1.  Qni Y, Peno E, Di J, Zemog E, Uim D, Wmog D, nt md. Nvmdumtiho hf Snomd Mrtnry io Eypnrtnosivn Qmtinots cy ^onoemo`nk LS Mogihgrmpey ^siog Ppmtimd Dmcndiog Wite Ludtipdn Iovnrsiho Qudsns Pnquno`n mok cy @[ Mogihgrmpey. Mlnri`mo Jhuromd hf Shnotgnohdhgy Shnotgnohdhgy.. = kn ohvinlcrn kn 31=32=99(>):==;3-5. ==.  Enrnknrh H, Qmdm`ihs M, M, Nguìduz Q. Shturm kn riýðo no enrrmkurm. Mr`e Mr`e.. Nsp. ^rhd. RIotnront\. 3119R@itmkh nd 1= kn Ohvinlcrn Ohvinlcrn knd 3131\2 63( 3 ): =0=-=00. K Kisphoicdn isphoicdn no: ettp://s`indh.is`iii.ns/s`indh.pep8s`ript