# 阻塞性肾病（Nephropathy Obstructive）

- 器官 / 系统：肾脏 / 泌尿系统（kidney / urinary-system）
- NTP 数据编号：ntp-0184
- 规范 URL：https://www.labsmart.cn/ntp/kidney-nephropathy-obstructive.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#kidney-nephropathy-obstructive
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/NephropathyObstructive
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
梗阻性肾病（obstructive nephropathy）可能由与结晶沉积相关的炎症、逆行性肾病（retrograde nephropathy）或下尿路流出道阻塞引起。

## 病变描述（中文）
梗阻性肾病（obstructive nephropathy）可能由与结晶沉积相关的炎症、逆行性肾病（retrograde nephropathy）或下尿路流出道阻塞引起。无论病因如何，均可观察到相似的形态学改变。逆行性（反流性）肾病是梗阻性肾病的一种形式，与一种反流现象有关，其特征为小簇状扩张的肾小管从肾乳头向皮质延伸，这是由于下尿路改变导致尿液反流增加所致（Figure 1、Figure 2）。导致梗阻性肾病的下尿路病变并非总能通过显微镜检出，因此其发病机制可能仍不明确。肾小管特征通常包括皮质嗜碱性肾小管灶或区域，伴有远端肾小管和集合管扩张（Figure 3、Figure 4）。管腔内炎症细胞或伴随的上行性肾盂肾炎可能存在，也可能不存在。消退中的病变可导致纤维化条带。

## 诊断与分级建议（NTP 共识，中文）
梗阻性肾病应当作出诊断并给出严重程度分级。相关病变如炎症和纤维化，仅当其为主要特征时才应单独记录。每当观察到梗阻性肾病时，均应检查下尿路以寻找病因。继发于肿瘤的梗阻性肾病不应单独诊断，而应在病理学描述中予以描述。相关链接：肾脏 - 结晶；肾脏 - 肾病，慢性进展性

## 英文原文 · Comment
Obstructive nephropathy may result from inflammation associated with deposition of crystals, retrograde nephropathy, or a lower urinary tract outflow blockage. Whatever the cause, similar morphologic changes can be observed. Retrograde (reflux) nephropathy, a form of obstructive nephropathy, is related to a backflow phenomenon characterized by small clusters of dilated tubules that ascend from the papilla to the cortex and are due to increased urine reflux resulting from changes in the lower urinary tract ( Figure 1 and Figure 2 ). Lesions of the lower urinary tract contributing to obstructive nephropathy may not always be detected microscopically,and thus the pathogenesis may remain unclear. Tubule features often include foci or areas of cortical basophilic tubules with distal tubule and collecting duct dilation ( Figure 3 and Figure 4 ). Intraluminal inflammatory cells or an accompanying ascending pyelonephritis may or may not be present. Resolving lesions may result in tracts of fibrosis.

## 英文原文 · Recommendation
Obstructive nephropathy should be diagnosed and given a severity grade. Associated lesions such as inflammation and fibrosis should be recorded separately only if they are very prominent features. Whenever obstructive nephropathy is observed, the lower urinary tract should be examined for the cause. Obstructive nephropathy secondary to a neoplasm should not be diagnosed separately but should be described in the pathology narrative. Related Links: Kidney - Crystals Kidney - Nephropathy, Chronic Progressive

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1090.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1089.jpg

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