An adolescent girl was admitted to the William Beaumont Army Medical Center, El Paso, Tex, with fever and costovertebral angle tenderness. The presumptive diagnosis was an upper urinary tract infection (UTI), which was subsequently confirmed and treated. She had been treated for UTI twice previously, once at the age of 5 years and again several months before admission. Her BP was 130/90 mm Hg and remained at that level during hospitalization. An intravenous urogram (Fig 1) and, subsequently, an abdominal aortogram (Fig 2) were obtained. Renal vein plasma renin activity showed a right-left ratio of 1.8 to 1. Right nephrectomy was undertaken. Her BP after nephrectomy was normal and has remained normal at two years' follow-up.
Denouement and Discussion
The most specific criteria for the diagnosis of Ask-Upmark kidney or "segmented hypoplasia" are histologic. There are remnants of cortex and medulla in a localized atrophic area that is