Renal ischemic changes at the cellular level were studied in difficult renal stone surgery cases requiring renal pedicle occlusion for various time intervals. By correlating these findings with the clinical course and subsequent return of kidney function, an attempt has been made to determine the safe clamping time. The characteristic findings of renal cell carcinoma noted as specific cell membrane changes verified those seen by other investigators. In this experience the proximal renal tubule appeared to be the primary cell origin of the neoplasm. Papillary transitional cell carcinoma of the renal pelvis was found to be analogous to that seen in bladder cancer. The scarsity of tight cell junctions found in these cases leads to the speculation that the cancer cells easily detach themselves and seed in the ureter and bladder. The epithelium of the polycystic kidney undergoes extensive changes as one would expect in terms of markedly reduced function. The ultrastructural details may have been modified by extrinsic pressure influences and therefore cannot be easily explained. A fruitful field for further study has been revealed.

Keywords:
Renal ischemia, Renal cell carcinoma, Urological kidney diseases, Electron microscopy, significance, Renal stones, surgery
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© 1971 S. Karger AG, Basel
1971
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