Hydronephrosis reasons. Hydronephrosis

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What is hydronephrosis?

Hydronephrosis - this is a pathology, accompanied by the expansion of the renal calyx-pelvis. With hydronephrosis, urine begins to accumulate in the structures of the kidney due to its impaired outflow into the ureter. Gradually accumulating, it leads to atrophy of the renal tissue and the development of renal failure.

Hydronephrosis reasons

In order to understand the symptoms of hydronephrosis, you need to know what the kidneys are. An elementary knowledge of the structure of this organ will help to understand the cause of hydronephrosis and its consequences.

Kidney structure

The kidney is a bean-shaped organ that performs the functions of urination. In the structure of the kidney, two parts are distinguished - the parenchyma of the kidney and the calyx-pelvic apparatus, which passes into the ureters.

Kidney parenchyma
Parenchyma ( that is, the kidney tissue itself) has a heterogeneous structure and consists of cortex and medulla. The cortex is dark in color and contains renal glomeruli. The main function of this part of the kidney is to filter and generate primary urine. The medulla of the kidney has a lighter shade and consists of renal tubules. The function of the medulla is to form a secondary ( final) urine and excretion of metabolic products from the body.

Pyelocaliceal part of the kidney
This part of the kidney is responsible for the accumulation and further excretion of urine into the ureter. After the blood passed through the kidney tissue, the liquid part was filtered from it and urine was formed. Urine collects in structures called cups. In the kidney, there are from 6 to 10 small cups and up to 4 large ones. The large calyces open into the pelvis, which in turn pass into the ureter. The pelvis is a funnel-shaped cavity in which urine accumulates. The pelvis and calyx are composed of mucous membranes and muscular membranes. Due to the contractions of the muscle layer, urine from the pelvis passes into the ureter, and from it into the bladder. Thus, a continuous accumulation of urine occurs in the cups and pelvis, which subsequently flows into the ureters. If something hinders the outflow of urine, then it begins to accumulate in the pelvis. Most often, stones, tumors, or narrowing of the ureter prevent the flow of urine from the pelvis.

If urine long time accumulates, then it begins to squeeze the renal tissue. Under constant pressure, the parenchyma ( the cloth) the kidney begins to atrophy ( ceases to function).

The causes of hydronephrosis are:

• tumors;
• abnormalities of the urinary system.

Urolithiasis disease

When urolithiasis the formation and deposition of kidney stones ( pelvis or cups), ureters or bladder. Wherever these stones form, sooner or later they lead to a violation of the outflow of urine. The formation of stones in the calyx-pelvis system already in the early stages leads to the development of hydronephrosis. With their volume, they close the lumen, thereby preventing the passage of urine into the ureter. When urine accumulates to a certain size, it stretches the cups and pelvis. Then she begins to squeeze the parenchyma itself, leading to its atrophy.

Tumors

Violation of the outflow of urine can also be a consequence of squeezing the kidney or ureter from the outside. This compression may be due to a growing tumor, cyst, or enlarged lymph node... Compressing the ureter or kidney, the volumetric formation prevents the normal flow of urine in these structures.

Abnormalities of the urinary system

Filtered urine is collected in the pelvis, from where it enters the ureters. If urine encounters any obstacles on its way, then its further path is suspended. Such an obstacle may be a congenital anomaly of the ureter or the calyceal system.

Ureteral abnormalities that can cause hydronephrosis include:

• Narrowing of the initial section of the ureter - with this anomaly, urine passes further, but not in the entire volume. Due to the narrowed ureter, some of the urine remains in the pelvis and begins to accumulate over time.
• Curvature of the ureter - also prevent the complete outflow of urine from the pelvis. Curvatures can be acquired ( adhesions due to previous infections) and congenital.
• High ureteral discharge - similarly complicates the flow of urine through the ureter.
• Ureteral valve defect - this anomaly, as a rule, is detected in the first years of life, because it is accompanied by a total retention of urine in the pelvis. The valve is a mucosal flap that closes the lumen of the ureter.

Anomalies of the urogenital system also include congenital atony of the urinary tract. With this anomaly, the muscle layer that makes up the ureters and the bladder is not capable of full contraction. Normally, the movement of urine along the urinary tract is provided by rhythmic contractions of the ureter. However, with atony, the ureter does not contract and, as a result, does not provide an outflow of urine.

The result is stagnation and accumulation of urine, first in the ureter and then in the kidney. At the same time, hydronephrosis can also be a consequence of hypertonicity ( stresses) the ureter. This pathology ( which is also called dyskinesia) is expressed in frequent and irregular contractions of the ureter.

Often, hydronephrosis is a consequence of vesicoureteral reflux. With this pathology, urine is thrown from the bladder into the ureter, and from there, as it accumulates, into the kidney.

Hydronephrosis symptoms

The main symptom of hydronephrosis is a dull aching pain, the localization of which depends on the localization of the pathological process. Sometimes the pain can take on the character of renal colic. Most often this happens if the cause of the pathology is urolithiasis. Also, the clinical picture of hydronephrosis is supplemented by symptoms of the underlying disease. If an infection joins this disease, then symptoms of general intoxication appear in the clinical picture.

Hydronephrosis on the right
With this type of hydronephrosis, the expansion of the calyx-pelvis system occurs in the right kidney. Most often, this anomaly is asymptomatic for a long time. Patients may complain of dull, moderate pain on the right. Pain syndrome may be accompanied by mild fever, nausea, weakness. As a rule, for a long time, hydronephrosis is erased, and it can only be detected during laboratory tests.

The symptoms of hydronephrosis are:

• blood in urine - if the cause of hydronephrosis is kidney stones, then hematuria ( or blood in urine) is a common symptom;
• elevated temperature - is noted when hydronephrosis is accompanied by pyelonephritis ( urinary tract infection);
• - a symptom that is noted already in the late stages of hydronephrosis;
• swelling - also appear in decompensated stages;
• decrease in daily urine output ( or oliguria) - less than 500 milliliters in 24 hours, at a rate of 1.5 liters.

Localization of pain syndrome with hydronephrosis on the right can often mimic the picture of appendicitis or hepatic colic. A sharp increase in pain can be triggered by a total ( complete) obstruction ( blockage) of the renal pelvis or kink of the ureter. This condition is urgent and requires immediate hospitalization of the patient.

Hydronephrosis on the left

Hydronephrosis of the left kidney is characterized by dull, aching pain on the left. Pain can also take on the character of renal colic. The pain syndrome takes on an acute, burning, unbearable character. In this state, the patient literally rushes about, cannot find a place for himself or hold out in one position for several seconds. A similar picture is characteristic of the migration of a kidney stone ( when a kidney stone travels down the urethra) or with a sharp squeezing of the ureter.

Also hydronephrosis on the left is accompanied by the development of edema, high blood pressure, a decrease in daily urine output ( urine volume). However, all these symptoms develop already in the last stages of hydronephrosis. In addition to dull, unexpressed pain in the early stages of the disease, there may be a symptom such as blood in the urine ( medical term - hematuria). It can be of two types - macroscopic and microscopic. In the first case, the presence of blood in the urine is visible to the naked eye. The patient himself notices that the urine has changed color and acquired a red tint. In the second case, the presence of blood elements in the urine is confirmed only by laboratory methods.

Hydronephrosis is often complicated by the addition of an infection and, as a result, a rise in body temperature ( manifestation of an infectious process). This is explained by the fact that with hydronephrosis, the process of stagnation of urine is noted. Due to the disturbed outflow from the pelvis, urine is retained in the kidneys. This becomes the soil for the development of bacteria in it ( if there is no movement process, then bacteria very quickly attach to the substrate, in this case - to urine). The result is a rapid infection of the urine and the transition of inflammation to the kidneys. Against the background of hydronephrosis, pyelonephritis also often develops, which is also accompanied by an increased body temperature and dull pain in the lower back.

Bilateral hydronephrosis

Bilateral hydronephrosis is usually a congenital pathology. But also ( although rarely) it can be triggered by urolithiasis, squeezing of the kidney or ureter from the outside by a tumor, a lymph node. Since the process affects both kidneys at once, renal failure develops very quickly.

The symptoms of kidney failure are:

• swelling;
• high blood pressure;
• the presence of protein in the urine ( proteinuria);
• delay in the body of urea and other metabolic products.

Edema is the result of massive loss of proteins by the body. In renal failure, the filtration process of primary urine is disrupted. As a result, proteins, namely albumins, are lost in the urine. In a healthy body, albumins form oncotic pressure, that is, they keep water in the bloodstream. When there are not enough proteins, water from the bloodstream goes into the tissues and soaks them. This is how renal edema develops. In renal pathology, the edema is warm, soft, yellowish. First of all, they are localized in areas of loose tissue, for example, around the orbit. The more protein leaves in the urine, the more pronounced the swelling.

A persistent and difficult to treat symptom in hydronephrosis is also arterial hypertension ( high blood pressure). It develops as a result of atrophy and insufficient blood supply to the kidneys. As you know, the accumulating urine in hydronephrosis compresses the kidney tissue, which leads to its atrophy. This leads to the activation of the renin-angiotensin system, which triggers a cascade of reactions, the final result of which is an increased secretion of the hormone angiotensin II. In turn, angiotensin II constricts blood vessels and stimulates the secretion of aldosterone. Aldosterone retains water in the body, and water retention plus constricted vessels is high blood pressure.

Together with urine, the kidneys excrete waste products of the body, including such toxic ones as urea and creatinine. These foods are very toxic, and, quickly penetrating the brain, can cause encephalopathy ( brain disease). This condition is the final stage of hydronephrosis. A characteristic symptom of the disease at this stage is the specific smell of urea from the patient.

Degrees ( stages) hydronephrosis

There are several stages in the development of hydronephrosis. The duration of these stages depends on the severity of the underlying disease and on the presence of concomitant diseases. The final or terminal stage of hydronephrosis, as a rule, already coincides with renal failure.

The stages of hydronephrosis include:

• the initial stage of hydronephrosis;
• early stage of hydronephrosis;
• terminal stage of hydronephrosis.

Stage 1 hydronephrosis

At this stage, the renal calyceal apparatus is enlarged, but this is not accompanied by an increase in the organ itself. Kidney function is preserved, the clinical picture can manifest itself with symptoms such as aching pain in the lumbar region. Sometimes hematuria ( blood in urine). In the analyzes, the protein may be slightly increased, with hematuria, erythrocytes will also be present.

Stage 2 hydronephrosis

In the second stage, the kidney itself increases simultaneously with the pelvis. On average, it increases by 10 to 20 percent of its original volume. However, it should be understood that the enlargement of the kidney does not occur due to an increase in its tissue or function, but due to the stretching of the pelvis and the accumulation of urine in them. The very same function of the kidney is reduced by 30-40 percent. Protein begins to appear in the urine ( proteinuria), and toxic metabolic products - creatinine and urea - grow in the blood. At this stage, the first signs of renal failure begin to appear - blood pressure rises, renal edema appears in the morning.

Stage 3 hydronephrosis

Represents renal failure. At this stage, the kidneys almost double in size, while their function is reduced by more than 60 to 70 percent. Parenchyma of the kidney ( her fabric) almost completely atrophies, and large cavities form in its place. The kidney takes on the appearance of a multi-chambered cavity, which, in turn, is filled with urine residues. Arterial hypertension becomes resistant ( does not respond well) to treatment, the pressure is constantly increased. Protein continues to be lost by the body, at the terminal stage proteinuria reaches 3 grams per liter of urine. This massive loss of protein causes large swelling. Patients at this stage are very edematous, edema is observed not only in the eye area, but also throughout the body.

Diagnosis of hydronephrosis according to ICD

Diagnosis of hydronephrosis is primarily based on laboratory and instrumental data. Objective data ( that is, patient complaints) are not very informative, since in the early stages of the disease the clinical picture of hydronephrosis is very poor. Periodic dull pain and blood in urine ( complaints with which the patient goes to the doctor) are insufficient to make a diagnosis. Therefore, the doctor prescribes special tests and analyzes. According to the international classification of diseases ( ICD) hydronephrosis is coded with code N13.6.

Analyzes for hydronephrosis

A urinalysis and a blood test are done to make a diagnosis.

Indicators of urine analysis for hydronephrosis

In parallel, the patient has severe edema ( due to protein loss) and persistent arterial hypertension.

Blood test indicators for hydronephrosis

Laboratory sign	Description
Hypoproteinemia	Decrease in the concentration of total protein in the blood less than 65 grams per liter.
Hypoalbuminemia	A decrease in predominantly albumin ( high density proteins), less than 25 grams per liter.
Hyperlipidemia	Diet positions for hydronephrosis are as follows: limited intake of animal protein; exclusion of certain products; the use of the required amount of plant products. Limited intake of animal protein With hydronephrosis, it is recommended to consume no more than 0.5 grams of protein per 1 kilogram of the sick person's weight. So, if a patient weighs 70 kilograms, he can eat 35 grams of protein per day. The protein norm should be replenished with lean fish or meat, dairy products of low fat content. In this case, you need to choose natural ( not frozen, not processed) products. Products that are allowed for hydronephrosis are: meat ( chicken, turkey, veal); offal ( liver); fish ( cod, walleye, pike); dairy and fermented milk products ( cottage cheese, kefir, milk, sour cream, yogurt). Exclusion of certain products There are some foods that should be reduced in hydronephrosis. Refusal from these products will have a positive effect on the general condition of the body and will allow you to more effectively resist the disease. Foods that should be removed from the diet for hydronephrosis are: any types of meat or fish with high fat content; jellied meat and other types of rich broths from meat or fish; dishes prepared by the method of frying, smoking, drying; industrial and home preservation ( salted, pickled, pickled vegetables or fruits); sweets, cakes, baked goods and other products with a large amount of sugar; foods with high salt content ( chips, crackers, salted straws); any food that has an unnatural smell, color, or taste. carbonated drinks, alcohol. Eating the right amount of plant foods With hydronephrosis, it is recommended to include at least 600 grams of fruits and vegetables in the daily diet. Vegetable products should be eaten mostly raw. The most beneficial crops for hydronephrosis are: potatoes; Folk remedies for the treatment of hydronephrosis In the treatment of hydronephrosis, it is advisable to use products made according to recipes of traditional medicine. These drugs should be used as an adjunct to the main treatment. Carrying out therapy with alternative methods requires adherence to a number of rules. Failure to follow the rules can cause various complications. Rules for the use of traditional medicine Before carrying out therapy with alternative methods, you should definitely make a visit to the doctor. The doctor will determine the appropriateness of such treatment and establish whether there are contraindications. Also, a physician can provide recommendations on the optimal regimen for taking alternative drugs. For the treatment to be safe and effective, you must follow the rules for the preparation and use of traditional medicine. The rules for treating hydronephrosis with folk remedies are as follows: Throughout the entire period of taking folk remedies, you should adhere to a special therapeutic diet. Also, during treatment, you need to limit alcohol consumption to a minimum. Before taking any remedy, be sure to do an allergy test. To do this, the first 2 - 3 times to use the drug in the minimum dose ( less than the one indicated in the recipe 5 - 7 times). The components from which the drug is prepared must be purchased at specialized places ( pharmacies, shops). It is not recommended to purchase medicinal products in places of unauthorized trade. All components for the preparation of folk remedies are used in a crushed form. Use a meat grinder, blender or food processor for chopping. It is necessary to store herbal preparations in glass containers or bags made of natural fabric. During storage, the contact of raw materials with air should be limited. The shelf life of the prepared product does not exceed 12 hours. Therefore, every day it is necessary to prepare a new portion of the drug. With hydronephrosis, all folk remedies are used in the form of a decoction. To do this, pour the required amount of raw materials with warm water ( indicated in the recipe) the required volume of warm water ( also indicated in the recipe). Then the composition must be put in a water bath and kept for 20 - 30 minutes. After that, the broth must be insisted for 1 - 2 hours, filtered and taken orally. The duration of treatment with folk remedies for hydronephrosis is 2 to 3 months. After each month, you need to pause for 2 weeks, and then return to treatment. Folk recipes for the treatment of hydronephrosis For hydronephrosis, a variety of herbs, vegetables, and other natural foods are used. Traditional medicines can improve the functionality of the kidneys, reduce pain, and reduce intoxication of the body. Products that are used for hydronephrosis are: pumpkin ( stalks, juice); beans ( sash); parsley ( root, seeds); herbal preparations. Pumpkin recipe For hydronephrosis, a pumpkin stalk is used ( the part that attaches the vegetable to the stem). For one-time cooking ( daily) portions of decoction from the stalk, you must use 2 tablespoons of raw materials and 2 glasses of water. The finished broth should be consumed during the day. Also, in the treatment of hydronephrosis, fresh pumpkin juice can be used. You need to prepare the drink yourself, since the ready-made juice in packages does not have sufficient healing properties. The recommended rate is 200 to 300 milliliters per day. Bean leaf recipe To prepare the broth, dry beans are used. The daily rate of this product is 750 - 1000 milliliters, which you need to drink in 6 - 7 doses. To prepare one serving of the broth, you need to use 4 tablespoons of bean flaps per liter of water. Parsley recipe A daily portion of the broth is prepared from 50 grams of fresh parsley root and water, in a volume of one glass. You need to drink the product 4 times a day for a tablespoon. The optimal time for using the broth is half an hour before a meal. For hydronephrosis, parsley seeds are also useful, from which medicinal drink... The daily volume of the drink is prepared from a tablespoon of seeds and 250 ml of water. The agent is taken 50 milliliters 3-4 times a day. Herbal recipes For hydronephrosis, various herbal preparations are used, which include several medicinal plants. To prepare the collection, you need to mix the ingredients in the proportions indicated in the recipe, and then pour them into a convenient container for storage. Subsequently, a drink is prepared from the collection, for a daily portion of which a tablespoon of raw materials and a glass of water are used. A decoction is being prepared traditional method - first kept in a water bath, then filtered and taken orally. The daily portion of the broth should be divided into 3-4 parts and drunk before meals. Herbal recipes for hydronephrosis Consequences of hydronephrosis The consequences of hydronephrosis are manifested by various pathologies, as a result of which the functionality of the kidneys and the general condition of the body deteriorate. Complications develop in case of late detection or inadequate treatment of the disease. The most common consequences of hydronephrosis are: accession of a bacterial infection; raising blood pressure; the appearance of solid formations in the kidneys; renal failure. Attachment of a bacterial infection The development of a bacterial infection is a common consequence of hydronephrosis. With this disease, the normal functionality of the urinary system is disrupted, which leads to improper outflow and stagnation of urine. All this creates conditions conducive to the reproduction of bacteria and the development of the bacterial process. The most common form of bacterial infection associated with hydronephrosis is secondary pyelonephritis ( inflammatory kidney disease). The mechanism of development of pyelonephritis In most cases, E. coli provokes pyelonephritis. It can also be Pseudomonas aeruginosa, Proteus, Klebsiella. These microorganisms live in the intestines as part of the normal microflora. But when they enter other organs, an inflammatory process develops. Along the ascending pathways, the infection enters the kidney cavity and pyelonephritis begins. Quite often, the disease takes a recurrent ( systematically recurring) or chronic form. In female patients for a reason anatomical features complication in the form of pyelonephritis is more common. In women, the urethra ( urination channel) more in width, less in length and is located closer to the anus. These features female body increase the likelihood of penetration of infectious agents into the kidneys. Symptoms of secondary pyelonephritis Secondary pyelonephritis begins with an increase in temperature, which can reach 39 - 40 degrees. The patient is worried about the general signs of infection, which are expressed by headache, chills, aching muscles and joints. There may also be nausea, vomiting ( periodically), heavy sweating. Heart rate ( pulse) increases, breathing becomes rapid, the tongue is dry. The patient behaves apathetically, sluggishly. A few days later, in the development of the infectious process, local symptoms also join the general signs. Local manifestations of pyelonephritis are: back pain ( on the side where the infection develops); increased pain at night, with coughing, deep breath; abdominal muscle tension ( determined by palpation); problems with urination. Pain that bothers the patient in the lumbar region, as a rule, radiates to upper part abdomen, groin area, thigh. The feeling of pain is more pronounced when a person lies on his back or on the side opposite to the zone of localization of the infectious process. As mentioned above, pyelonephritis with hydronephrosis often becomes chronic. Like the acute form, the chronic stage of bacterial renal infection is accompanied by local and general symptoms. In comparison with primary pyelonephritis, which develops as an independent disease, the manifestations of infection in hydronephrosis are more pronounced. The patient may be disturbed by a dull aching pain in the lumbar region, which most often appears during a period when it is damp and cold outside. Painful sensations can spread to other organs and parts of the body ( with primary pyelonephritis, this rarely happens). The general symptoms of chronic kidney inflammation, which develops against the background of hydronephrosis, are divided into early and late. TO general symptoms pyelonephritis, which appear at the beginning of the disease, include: fast fatiguability ; general weakness that occurs periodically; subfebrile temperature ( from 37 to 37.5 degrees); increased blood pressure ( in about half of patients). Often in the middle of the day in patients with chronic pyelonephritis there is a desire to take a horizontal position due to fatigue. This is due to the fact that the outflow of venous blood becomes difficult in the kidneys with prolonged standing on the legs. A late symptom of secondary pyelonephritis in the chronic stage is dryness of mucous tissues. oral cavity... At first, dryness appears from time to time, and subsequently becomes permanent. The patient begins to worry about heartburn, belching. A person's appearance changes - the skin becomes pale, the face takes on puffy outlines. People with chronic inflammation of the kidneys are characterized by passive emotional behavior, which manifests itself in a lack of interest and initiative, inaction, and apathy. Increased blood pressure With hydronephrosis, the affected kidney begins to synthesize in an increased volume the hormone renin, which provokes an increase in blood pressure. As a result, nephrogenic hypertension develops, which does not respond well to drug therapy. The mechanism of development of nephrogenic hypertension With hydronephrosis, blood circulation in the affected kidney decreases, due to which the secretion of fluid decreases. As a result, severe edema develops and the blood vessels narrow. In addition, the walls of the vessels become more sensitive to the action of certain substances, as a result of which the vessels begin to contract. Circulatory disorders and vasoconstriction provoke increased renin synthesis, as a result of which nephrogenic hypertension develops. Symptoms of Nephrogenic Hypertension A distinctive characteristic of nephrogenic hypertension is an increase, mainly of the lower ( diastolic) pressure. This condition is poorly corrected by drugs that are designed to lower blood pressure. Also, patients are worried about a strong headache in the back of the head or in the forehead. Painful sensations may be accompanied by dizziness. Against the background of narrowing of the blood vessels, the nutrition of the retina of the eye is disrupted, which leads to vision problems that progress rapidly. Other symptoms of nephrogenic hypertension are: a strong feeling of thirst; increased urination; nausea, vomiting; a sharp increase in temperature; swelling. Sometimes nephrogenic hypertension is accompanied by disorders of the nervous system, due to which patients become excessively whiny, irritable. In the absence of timely treatment, due to narrowing of the blood vessels, cerebral dysfunction, heart failure can develop. The appearance of solid formations in the kidneys The appearance of solid formations in the kidneys ( urolithiasis disease) can be both a cause and a complication of hydronephrosis. If urolithiasis develops as a consequence of hydronephrosis, it is characterized by the formation of struvite stones, which are also called infectious. The mechanism of the appearance of solid deposits in the kidneys Impaired urine flow and bacterial infections, which are characteristic of hydronephrosis, form a favorable environment for the formation of struvite stones. Bacteria such as Proteus, Pseudomonas aeruginosa and Klebsiella break down urine urea, which leads to the formation of sediments from which a stone is formed. Such formations consist of deposits of magnesium, ammonium, calcium carbonate. Infectious kidney stones rapidly increase in volume and, due to their specific shape, are also called coral stones. Symptoms of the presence of kidney stones Symptoms typical of urolithiasis such as acute stabbing pains in the back or lower abdomen with struvite stones are not so pronounced or absent at all. Patients may complain of general deterioration, dry mouth, and fever. If untreated, such stones can provoke a general purulent infection ( sepsis), renal failure, shrinkage and kidney loss. Renal failure Renal failure is one of the most serious complications of hydronephrosis and sometimes leads to irreversible consequences. The mechanism of development of renal failure With hydronephrosis, the pressure in the kidney increases, due to which the parenchyma ( tissue covering the kidney) decreases in volume and gradually atrophies. The blood supply to the organ is also disrupted. As a result, the excretory function of the kidneys decreases, and harmful substances begin to accumulate in the blood ( nitrogenous slags), which are normally excreted from the body along with urine. Kidney failure symptoms The symptoms of renal failure depend on the background of what form of hydronephrosis this complication developed. The acute stage of hydronephrosis leads to acute renal failure. With this complication, the kidneys lose their functions within a very fast time ( from several weeks to several days). Therefore, when identifying symptoms of a developing complication, it is necessary to immediately seek medical help. The symptoms of acute renal failure are: a sharp decrease in urine volumes ( first up to 400 milliliters per day, then - no more than 50 milliliters per day); an increase in body volume ( due to accumulating liquid); widespread itching of the skin; drowsiness, lethargy; nausea, vomiting, loose stools; swelling of the face, ankles; loss of appetite; In the absence of timely medical intervention, shortness of breath develops, because a large amount of fluid accumulates in the lungs. Hemorrhages and bruises appear on the body. Involuntary muscle contractions may appear ( cramping), hallucinations, loss of consciousness. In chronic hydronephrosis, the decrease in kidney functionality occurs gradually and in most cases is imperceptible ( in the early stages) for the patient. As chronic renal failure progresses, it provokes general weakness, decreased performance, and frequent headaches. The body weight in patients begins to decrease, the skin becomes yellow. Other symptoms of chronic renal failure include: dry mucous membranes in the mouth, ammonia smell; bleeding gums, bruising on the body; violation of the menstrual cycle ( among women); persistent increase in blood pressure; increased susceptibility to disease ( due to reduced immunity). Before use, you must consult with a specialist.

When there is an expansion of the renal-pelvic system, doctors, as a rule, say that the patient has begun hydronephrosis of the kidney or develops hydronephrotic transformation of the kidney. This occurs as a result of an increase in intrarenal hydrostatic pressure due to poor outflow of urine and an increase in the amount of fluid.

In which, gradually, due to a strong narrowing of the channels, the organ tissues die off. In particular, this disease is characterized by the fact that the disease is noted as hydronephrosis of the left kidney or only hydronephrosis of the right kidney. That in the practice of physicians are found equally often.

The nature of the pathology by stages

The symptoms of hydronephrosis in each person proceed depending on the stage of development:

• The initial stage often passes unnoticed by the patient himself, since it has practically no symptoms. However, with an ultrasound scan, the doctor can determine the onset of the disease by the enlarged contours of the left or right kidney.
• In the second stage, the renal structures are narrowed due to the increased fluid content in the organ. In this case, the affected kidney begins to function worse, thereby enhancing the work of the healthy side.
• With the onset of the third stage, the part of the organ affected by hydronephrosis completely ceases to participate in the formation and excretion of urine from the body. When a healthy kidney is no longer able to work with a vengeance, it weakens as a result. Which is characterized by renal failure and the risk of death from hydronephrosis.

Features of the symptoms of the disease

It is important to undergo a medical preventive examination to identify any pathologies of the genitourinary system in advance. Since many diseases of the genitourinary system, including the treatment of hydronephrosis, must be started earlier, even when the disease did not have time to go into the second, and then already the third stage. After all, the absence of symptoms does not yet mean that a person does not have any hidden diseases.

If in the initial period of development, the hydronephrotic transformation of the right kidney or during the hydronephrotic transformation of the left kidney does not manifest itself in any way. When a healthy kidney still manages to fully compensate for the dysfunction of the affected side. Then, with each subsequent stage, the load on a healthy kidney increases, thereby wearing out its structure.

As a result, due to the increase in hydrostatic pressure in the diseased kidney, the patient feels aching painful and dull symptoms in the area of \u200b\u200bthe organ. Located in the lumbar region. When, nausea and vomiting, taken together, are also accompanied by flatulence in the intestines and an increase in body temperature.

Judging by the analysis, then in this case it becomes noticeably larger and it acquires a reddish tint. When, in the absence of treatment for hydronephrosis of the kidneys, the patient goes to the toilet less often, and due to the accumulation of excess fluid in the body, he has swelling of some parts of the body. The patient gets tired quickly, his skin becomes paler, an increase in blood pressure is observed.

Often, similar symptoms develop in other diseases, which in order to accurately determine the diagnosis of the patient, it is necessary to send for an ultrasound scan, urine analysis, and an X-ray, where the doctor can see clear changed contrasts of the affected organ on the monitor screen.

How hydronephrosis is treated

Treatment of hydronephrosis can take place in two directions: conservative and surgical. The first option is more often used to restore the kidneys in the first stage. The second is prescribed on the occasion of an exacerbation of the disease in conjunction with medication.

If the exit of urine from the bladder due to hydronephrosis after taking medication is also difficult. In addition, especially in the preoperative period, the attending physician, through a small incision in the skin, introduces a catheter into the bladder or artificial drainage of the kidney.

And also sometimes, before preparing the patient for the operation, it is necessary to give or inject the victim with anti-inflammatory and analgesic drugs. Allowing to relieve him of severe swelling of the kidney tissue and pain signs of hydronephrosis. When an operation is prescribed depending on the cause that was the result of hydronephrosis, there are the following features:

• Surgery to remove kidney stones.
• Excision of a portion of the affected canal that passes from the kidney to the bladder.
• If there is a pathology on the right or left side of the urinary system, which must be eliminated in order to restore the output of urine from the body. Then the doctor, maybe with the help surgical operation move the ureter relative to the bladder towards the absence of pathology.
• In very rare cases, the diseased kidney is completely excised or transplanted.

In particular, it is worth noting that for hydronephrosis of the kidneys, the treatment is the same at any age. When an important feature for getting rid of stress for both children and adults requires timely therapeutic intervention. That in the future, maybe, save from using the operation.

Etiological features of the disease

Kidney disease with hydronephrosis has two reasons why it occurs by congenital and acquired. What is congenital renal hydronephrosis? Firstly, it is a traumatic or infectious factor that has arisen in the womb and is abnormally reflected in the development of the kidneys in the fetus, and secondly, it may be associated with heredity.

If children get it less often, then in adults or young people it occurs for the following reasons:

• Decreased immunity against the background of hypothermia, which affected the functions of the genitourinary system.
• Urolithiasis disease.
• In women, hydronephrosis is detected against the background of uterine diseases.
• Oncology of the kidneys or organs abdominal.
• If there are disorders in the functions of the spinal cord, which can also affect the natural outflow of urine and cause its retention in the body.

Methods for diagnosing the disease

As a percentage, only 7-8% of people try to apply for medical help as a preventive measure. Basically, they end up with a doctor when they are forced to undergo examination after the transition of the disease to the second stage. That is why, during hydronephrosis of the kidney, the symptoms and their treatment take place so at the wrong time, namely when the situation compels due to the frequent presence of malaise in the lumbar spine, vomiting and nausea.

Perhaps for the reason, as doctors say, that the disease goes away at first without symptoms, when the compensation of the function of the affected left or right kidney is completely performed by the healthy one. However, such symptoms may not always indicate the presence of hydronephrosis of the kidney, which is necessary to fully inform the patient and the doctor's guesses, the patient is sent to such procedures:

• Ultrasound of the abdominal organs allows you to make a visual image on the equipment monitor. Where the doctor clearly defines the boundaries of the affected organ.
• X-ray scans to see if there are stones in them. That can also cause the manifestation of symptoms of hydronephrosis in the subject.
• By injecting the patient through a syringe, a substance that allows, when scanning, to give the organs of the genitourinary system a pronounced outline. That makes it possible during rehabilitation to track how much the selected treatment had a positive effect on the kidneys.
• Radionuclide kidney scan.

Diet therapy and preventive measures for hydronephrosis

What is the reason for the formation of renal hydronephrosis and what is it? More often, to such a question from their patients, doctors can say that in childhood it is more likely associated with congenital anomalies in the development of the genitourinary system. In adults, renal hydronephrosis is mainly manifested due to the following reasons:

• If you do not empty the bladder on occasion, that is, when you want to endure the toilet for a long time. When that urine that has already entered the bladder due to its retention, some of its contents again appear in the kidneys.
• As a rule, by often consuming salty foods, a person begins to consume more water when the kidneys do not have time to process the water that has entered the body. As a result, it disrupts the work of the left or right kidney, due to the content in the tissues of an uneven amount of salt and water.
• Constantly catch cold lumbar... That is, it is not necessary that in the cold season part of the back remains open, for example, if instead of a jacket with a long bottom, wear with a short one. Subsequently, such an attitude towards one's health may be reflected in ailments in the kidneys.

The effects of an unbalanced diet can also seriously affect the function of the genitourinary system. When in the treatment of hydronephrosis it is necessary to include, in addition to taking medications, diet therapy. But not independently, but according to the diagnosis. Those who prohibit eating salt, fatty foods, smoked meats and sweet foods while treating the symptoms of hydronephrosis, drinking alcohol in any form and quantity. That also excludes the use of hot spices in cooking.

If anything is allowed, it is fresh vegetables, fruits, protein products and dairy products. Only in this case it is possible to achieve positive results together with medication in restoring the functioning of the affected kidney.

Translated from the ancient language, hydronephrosis means the accumulation of water in the kidneys. Kidney hydronephrosis is considered very common among infants, but a similar pathology can be found in adults. Renal hydronephrosis is a pathology in which there is a slow outflow of urine from the organ into the bladder. As a result of such a functional disorder, urine accumulates in the renal pelvis, which triggers changes in the functions of the organ. When making a diagnosis, another name for the pathology is more common - hydronephrotic transformation of the right or left kidney. What if the doctor voiced this diagnosis?

Classification

For the correct selection of treatment tactics for this complex pathology, the specialist must know what phase of the pathology development, what caused its manifestation. To improve the quality of treatment, a classification of types of pathology was created. In urology, the classification of hydronephrosis consists of several parameters: time of development, degree of course, localization.

By development time

Congenital (primary)

Congenital hydronephrosis progresses due to intrauterine obstruction. Pathological enlargement of the renal pelvis has nothing to do with genetics. The congenital condition is considered a fairly rare anomaly. Only in 1% of all newborns there is a chance that one kidney will be pathological. Of all cases of pathologies, 15% are bilateral hydronephrosis.

Secondary (acquired)

Secondary hydronephrosis develops as a result of a previous illness. Right-sided hydronephrosis or hydronephrosis on the left can occur as a complication of such conditions:

• urolithiasis;
• neoplasms in the kidneys or abdominal organs;
• narrowing of the lumen of the urinary tract or stress compression;
• prolapse of the kidney.

At the place of concentration

According to the place of localization, it is classified:

• unilateral;
• double-sided.

Among all pathological cases, hydronephrosis of the right kidney occurs with equal frequency as hydronephrosis of the left kidney. The defeat of two at the same time is rarely diagnosed. Only 5% of all cases of renal impairment are bilateral pathologies.

Main degrees of severity

The kidney is able to recover on its own with the first degree of hydronephrosis.

Based on clinical practice, disease states were divided into 3 grades. In some sources, the classification includes 4 stages of hydronephrosis. At stage 4, the kidney does not work at all. But in practice, doctors use only three degrees. Each degree takes into account the state and severity of atrophy of the renal parenchyma. The duration of development of each degree is influenced by the severity of the main disease and additional (attached) ones. Hydroureteronephrosis of the last stage indicates the development of renal failure.

First degree. With 1 degree of hydronephrosis, the kidney is characterized by a slight expansion of the pelvis. This condition is called pyelectasis. The thickness of the walls of the pelvis allows for some time to resist stretching. Minor functional impairment may be seen. This is a mild degree of disorder, sometimes the kidney is able to recover on its own.

Hydrocalicosis

Second degree. With a significant expansion of the renal pelvis, hydronephrosis of the 2nd degree or hydrocalicosis is diagnosed. The fluid leaves the organ slowly and the organ increases up to 20%. The kidney tissue becomes thinner and atrophies. There is a significant violation of functionality, reaching 40%.

Terminal

Third degree. A hollow, thin-walled organ, resembling a chamber with cells filled with poorly concentrated urine. This condition of the kidney characterizes terminal hydronephrosis. Violation of the organ's functionality is clearly expressed (up to 80%) and its increase by 1.5-2 times. Complete tissue atrophy leads to the development of renal failure.

Reasons for the development of kidney hydronephrosis

Urolithiasis disease - common reason hydronephrosis.

If the causes of a congenital disease in children are anomalies in the development of an organ, then hydronephrosis in adults occurs with internal blockage of the urinary tract or any other reasons that provoke a violation in the functioning of the organ. One of the most common causes is urolithiasis. Blockage of the ureter with a stone - when exiting the kidney, it can block the normal outflow of urine in both men and women. Other causes of hydronephrosis in women and men may differ.

Reasons for hydronephrotic transformation in men:

• benign neoplasm of the prostate gland;
• malignant formation of the prostate gland.

Reasons for hydronephrotic transformation in women:

• period of pregnancy;
• the development of neoplasms in the organs of the genitourinary system.

Less common causes of kidney hydronephrosis include:

• the development of embolism as a result of injury to the walls of the urinary tract;
• abnormal proliferation of uterine tissue;
• tuberculosis;
• pathology of the nerve endings that control the bladder.

Pathology

The pathological and anatomical picture in renal hydronephrosis depends on the degree of anatomical damage to the organ and on the stage of development. At the first stage, the differences between a diseased kidney and a healthy one are hardly noticeable. All the changes occurring relate to the pelvis and cups. Gradually, intralocal pressure leads to an increase in the cups, the shape of the PCS changes. The necks of the cups become short, wide, and the cups themselves become round. The occurring atrophy of muscle fibers leads to a thinning of the walls. Nerve endings die, the condition of blood and lymphatic vessels... To the last degree of development of pathology, the renal pelvis is a sac with thin walls, which are connective tissue.

Symptoms of pathology

A common symptom of pathology is pain in the kidney area.

Signs of hydronephrosis have varying degrees of severity, which depends on the stage of development, on the speed of blocking urine output. But left-sided hydronephrosis has all the manifestations that a right-sided one will have. For example, if a stone leaves the urine in the duct or ureter when it leaves, the symptoms of hydronephrosis develop quickly, within a few hours. If the process develops gradually (weeks or months), the symptoms are insignificant or absent at all. In addition, the location of the pathology, the duration of the process and the size of the kidney affect the strength of the manifestation of signs.

Symptoms in adults are not much different from the symptoms of illness in children. The main symptoms include:

• pain in the kidney area (back);
• abdominal pain;
• nausea;
• blood in the urine;
• the temperature in hydronephrosis rises in case of infection.

Hydronephrotic transformation of both kidneys leads to the appearance of signs of renal failure (impaired urine outflow, increased blood pressure, edema).

Complications and outcome

A timely diagnosis and proper treatment will help prevent the development of renal failure.

What outcome will be if the kidney is blocked, whether it is possible to live with hydronephrosis depends on how timely the diagnosis is made and how correctly the treatment was chosen. The most dangerous forecast acute form - development of renal failure. The changes that have occurred in the kidney do not allow it to function normally and it stops working. As a result of the intoxication of the body in violation of homeostasis, death occurs.

The chronic course of the disease leads to the development of urolithiasis, an inflammatory process in the organ, and an increase in renal pressure. These outcomes further exacerbate the existing kidney problem. If an infection occurs against the background of hydronephrosis, the likelihood of developing sepsis is high.

Are the changes in the kidney and PCS reversible?

With the timely diagnosis of pathology, the process did not change the size of the kidney in a short period of time, therefore, the violations of functions that occurred do not carry significant changes, they are reversible. But with the chronic process of impaired urination, the kidney is deformed and the processes become irreversible. Renal tubules die, organ cells die, blood supply is disturbed.

Hydronephrosis can only be cured with surgical intervention.

With such a complex pathology, the treatment of hydronephrosis should be aimed at identifying and treating its cause, and, if necessary, contribute to the reduction of the pelvis, the preservation of the organ. Conservative therapy for hydronephrosis does not bring an effective result; it can be used only in the inflammatory process. Hydronephrosis is treated only with surgery.

Hydronephrotic transformation or hydronephrosis of the kidney is an ailment, as a result of which pathological stretching of the calyx-pelvic system begins. The pathological process is due to the fact that the process of urine outflow is disturbed in the kidneys. Typically, the disease affects only one kidney. Young women are most susceptible to the disease.

Etiology

Initially, it is worth noting that there is a distinction between congenital hydronephrosis and acquired. Congenital hydronephrosis can result from the following factors:

• obstruction of the urinary tract;
• wrong channel location.

As for the acquired form of this kidney disease, then, as a rule, it can develop against the background of such diseases:

• inflammatory processes in the genitourinary tract;
• urolithiasis disease;
• tumors of the uterus, urinary tract, prostate and ovaries;
• metastases, malignant processes in the abdominal cavity;
• spinal cord injuries that interfere with the natural flow of urine.

In addition, disturbances in the natural outflow of urine may be due to anatomical features.

Development stages

There are three stages of hydronephrosis of the left (right) kidney:

• compensated stage - at this stage, urine accumulates in the pelvic system in a small amount. Kidney functions are almost fully preserved.
• hydronephrosis of the 2nd degree - there is a strong thinning of the tissue, which leads to a decrease in the efficiency of the organ by 40%;
• the third stage - the organ is almost completely unable to cope with its functions, chronic renal failure occurs.

Symptoms

At an early stage of the development of the disease, there are practically no symptoms. In some cases, the patient may complain of the following symptoms:

• colic;
• more frequent urination, which does not bring adequate relief;
• feeling of heaviness in the area of \u200b\u200bthe organ.

As congenital or acquired hydronephrosis develops, a dull, aching pain in the lumbar region may be felt. The localization of pain depends on which kidney is affected. Further, you can observe the following symptoms:

• lower abdominal pain;
• weakness;
• high temperature;
• nausea;
• attacks of pain in the area of \u200b\u200bthe organs;
• bloating;
• high blood pressure.

If the patient has a fever (more than 37 o C), then this indicates the onset of an infectious process, especially when there is a suspicion of hydronephrosis in children.

In some cases, the patient does not have the above symptoms, except for one - urine mixed with blood. Such a violation requires immediate medical examination.

Hydronephrosis of the left kidney

Hydronephrosis of the left kidney is one of the most common diseases of the genitourinary system. The main trigger is a stone, which can block the flow of urine. Moreover, if a stone enters the urinary tract, bilateral hydronephrosis is considered.

The first and most common symptom of this disease is pain on the left side, which radiates to the leg. There is also a painful outflow of urine mixed with blood and mucus. In some cases, the patient cannot urinate, although the urge to urinate is present.

With such symptoms, you should immediately consult a doctor for an accurate diagnosis and immediate treatment. An operation is almost always prescribed.

Hydronephrosis of the right kidney

Hydronephrosis of the right kidney is a urological disease that is caused by a blockage of the urinary tract. The main risk group is the elderly and those who abuse alcohol.

Symptoms of hydronephrosis of the right kidney are the same as in the localization of the pathological process in the area of \u200b\u200bthe left kidney. The only difference is that with hydronephrosis of the right kidney, the pain radiates to the entire lower back.

Hydronephrosis in children

As a rule, hydronephrosis in children is a congenital disease. This pathology can occur in newborns if hydronephrosis is diagnosed during pregnancy. In newborns, pathology often affects both kidneys at the same time.

With the help of special diagnostics, it is possible to diagnose hydronephrosis in the fetus. Therefore, the congenital form of hydronephrosis in children is diagnosed much more often.

Hydronephrosis in the fetus and the reasons for the development of such a pathology in it can be determined even in the early lines, which makes it possible to start treatment in a timely manner, which means that it will be more effective. Such an ailment in newborns can be caused by the following factors:

• stenosis of the pelvic system;
• high discharge of the ureter;
• narrowing of the bladder neck.

Hydronephrosis in children is treated more successfully than in adults, as it is diagnosed in the early stages.

Treatment of hydronephrosis in children

Treatment of hydronephrosis in children and newborns is carried out only after accurate diagnosis and confirmation of the diagnosis. The mandatory diagnostic program includes the following:

• general analysis urine and blood;
• Ultrasound of the kidneys;

As a rule, the treatment of hydronephrosis in children is carried out only promptly and takes place in two stages:

• excision of tissue to widen the passage;
• anastomosis - suturing the ureter to the pelvis.

Such an operation does not pose a threat to life, subject to the competence of the surgeon. The rehabilitation period does not last long, but a diet is required for this period. This circumstance does not apply to newborns.

Hydronephrosis during pregnancy

Hydronephrosis during pregnancy has the same symptoms as listed above. It should be noted that hydronephrosis in this position develops more often in the right kidney than in the left. This is because the ureter is compressed due to the enlargement of the uterus.

It is very important to determine whether this disease was formed during pregnancy or was congenital. The fact is that hydronephrosis during pregnancy can cause the development of pathology in a newborn.

Operable intervention in this position is impossible. Typically assigned conservative treatment with minimal consumption of medicines. In this case, treatment with folk remedies is appropriate, but only as directed by a doctor. It is important to follow the diet, but without prejudice to the child.

Diagnostics

During the examination, the doctor can pre-diagnose hydronephrosis by palpation. In the area of \u200b\u200bthe organ, compaction is observed. The patient's symptoms and general health are also taken into account. For an accurate diagnosis, instrumental and laboratory tests are prescribed:

• x-ray examination of the kidneys.

Based on the analyzes, an accurate diagnosis is made and the correct course of treatment is prescribed. If it is impossible to make an accurate diagnosis based on the results of such studies, the doctor may prescribe a CT and MRI scan.

Treatment

In most cases, an operation is prescribed. Especially if the disease is diagnosed in children.

As for the treatment of the disease in adults, both conservative treatment and surgery are used. It all depends on the degree of development of the disease and the general condition of the patient. It is important to follow a diet for the period of treatment.

Conservative treatment is appropriate only at an early stage of the development of the disease. Within the framework of therapy, drugs of such a spectrum of action are prescribed:

• pain reliever;
• anti-inflammatory;
• to lower blood pressure;
• antibacterial (if there is an infection).

However, as practice shows, even at an early stage, the operation gives the best results.

Diet

Diet is not the last place in the treatment. The diet is prescribed by the doctor individually. The following foods should be excluded from the daily diet:

• salty;
• fatty;
• smoked;
• sweets;
• alcohol;
• fried meat and spicy dishes.

Instead, the diet should include the following:

• vegetables and fruits;
• dairy products;
• proteins.

Such a diet in combination with the right treatment gives positive results. By the way, diet can help improve metabolism, which is beneficial for the whole body.

Treatment with folk remedies

Folk remedies for the treatment of hydronephrosis are often used, but only in tandem with a medication method of treatment, and after consultation with a doctor.

Folk remedies for the treatment of this disease are presented in the form:

• herbal teas for oral administration;
• tinctures;
• compresses;
• warming lotions.

In tandem with the main course of treatment, such folk remedies will give positive results. Folk remedies are especially good at helping initial stage development of the disease.

Pay particular attention to the fact that treatment with folk remedies can be started only after the diagnosis is confirmed. Otherwise, their use may not only not help, but also aggravate the general condition of the patient. Therefore, when the first symptoms appear, which will indicate the development of pathology, you should immediately consult a doctor.

Hydronephrosis of the kidney is a complex and dangerous ailment. However, if the treatment of hydronephrosis is started in a timely manner, then the disease is completely cured without the development of complications.

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Hydronephrotic transformation or hydronephrosis of the kidney is a disease, the main symptom of which is the progressive expansion of the renal pyelocaliceal system. This pathology develops as a result of a violation of the outflow of urine, which leads to an increase in hydrostatic pressure in the cups and pelvis.

Due to the compression of the vessels, nutrition is disturbed, atrophy of the kidney tissue occurs and a significant deterioration in their functions. Most often, hydronephrosis occurs in young women. Typically, only one kidney is affected. Hydronephrosis of the right and left kidney occurs with the same frequency.

Causes of kidney hydronephrosis

The disease can be either congenital or acquired. Congenital hydronephrosis occurs as a result of the following reasons:

• dyskinesia of the urinary tract;
• congenital anomalies of the location of the renal arteries and their branches, compressing the ureter;
• improper location of the ureter behind the vena cava;
• congenital strictures, ureteral valves, urinary tract obstruction.

Acquired hydronephrosis develops with the following urological diseases:

• urolithiasis disease,
• inflammatory diseases of the genitourinary system,
• tumors of the urinary tract, uterus, cervix or ovaries, prostate,
• cicatricial narrowing of the urinary tract as a result of trauma,
• metastases or malignant infiltration of the pelvic tissue and retroperitoneal space,
• spinal cord injuries, leading to a reflex violation of the outflow of urine.

Violation of the patency of the urinary tract occurs due to anatomical obstacles, which are divided into 5 groups:

1. located in the bladder or urethra;
2. located at the level of the ureter, but not in the lumen;
3. caused by misalignment or kinking of the ureters;
4. localized in the lumen of the ureter or pelvis;
5. located in the wall of the ureter and pelvis.

1. The first stage of hydronephrosis is manifested by a slight accumulation of urine in the pelvis and a slight stretching of its walls. This is a compensated stage in which kidney function is maintained at a normal level.


2. At stage 2, hydronephrotic transformation of the kidney leads to a thinning of its tissue, which is accompanied by a decrease in function by about 40%. At the same time, the work of a healthy kidney is enhanced, which compensates for the excretory function.
3. The third stage of hydronephrosis (terminal) is characterized by a significant loss of kidney function or its complete shutdown. A healthy kidney cannot cope with the needs of the body, chronic renal failure progresses, which, if untreated, leads to death.

Symptoms of kidney hydronephrosis

Often, the development of hydronephrosis goes unnoticed. The disease has no specific symptoms. In the early stages, the clinical picture is due to the cause that caused the development of hydronephrosis. For example, with urolithiasis, attacks of renal colic may occur, characterized by severe acute pain along the ureters.

The most stable symptom is constant aching pain of a dull nature, localized in the lower back. Pain in hydronephrosis can disturb at any time of the day and regardless of body position. Their localization to the right or to the left depends on which kidney is affected. Hydronephrotic transformation of the right kidney can manifest itself as pain in the right abdomen, as in cholecystitis or liver disease. During painful attacks, nausea, vomiting, bloating, increased blood pressure sometimes occur.

An increase in body temperature is possible, which indicates an infection. Sometimes the only symptom of the disease is the discharge of blood in the urine. Approximately 20% of patients have macrohematuria, but microhematuria is much more common. This symptom is typical in cases where the cause of hydronephrosis is urolithiasis: calculi injure the walls of the urinary tract.

In the final stage of the disease, especially with bilateral hydronephrosis, signs of chronic renal failure appear. The amount of urine decreases, edema, anemia, and arterial hypertension occur.

Important: in case of pain in the lower back or abdomen, as well as the release of blood in the urine, it is necessary to undergo an examination.

Diagnostics of the kidney hydronephrosis

With an external examination and palpation, the doctor can reveal deformation and swelling of the lumbar region. Hydronephrotic transformation of the left kidney is detected on palpation in the form of a mass. In this case, it is necessary to differential diagnosis with splenomegaly and ptosis of the stomach, as well as tumors of the uterus and retroperitoneal space.

Laboratory diagnostic methods include a general analysis of urine and blood, various special urine tests - according to Nichiporenko, Zimnitsky and others.

Instrumental research methods

1. Ultrasound of the kidneys can reveal the expansion of the pelvic-pelvic system, enlargement of the kidney, and determine the thickness of the renal parenchyma.


2. X-ray examination is the basis for the diagnosis of renal hydronephrosis. With the help of plain radiography, you can determine the size of the kidneys, identify stones. With contrast intravenous urography, a series of images is taken and the nature of the rate of formation and excretion of urine is determined. With hydronephrosis, there is a slowdown in the flow of contrast into the renal pelvic system. The pelvis and calyx are widened and have rounded contours. In the later stages, the contrast agent may not enter the kidney affected by hydronephrosis at all. Sometimes you can identify the level and nature of the violation of the patency of the urinary tract.
3. Radioisotope urography makes it possible to more accurately determine the nature of dysuric phenomena, to characterize the degree of damage to each kidney separately.
4. Computed tomography and magnetic resonance imaging, as well as angiography are used in unclear cases to clarify the diagnosis.

Treatment of hydronephrotic kidney transformation

Do not despair if the examination has confirmed renal hydronephrosis: treatment selected by a qualified specialist will help improve organ function and compensate for the condition. In each case, the causes, degree and rate of development of hydronephrosis are taken into account. The main goal of treatment is to eliminate the cause of the disease.

Conservative treatment

Conservative therapy for hydronephrosis is symptomatic and used at an early stage. It includes pain relievers, anti-inflammatories, drugs to lower blood pressure, and others depending on the symptomatology. If an infection has joined, then appoint antibiotic therapy... Usually, conservative treatment precedes surgery.

Surgery

In most cases, organ-preserving surgeries are performed to eliminate the cause of the disease and restore kidney function. The operation is best done at an early stage of hydronephrosis, when the kidney changes are still reversible, especially with regard to congenital anomalies. Surgical treatment involves restoring the patency of the urinary tract, and in the later stages - plastic pelvis and restoration of its size.

The hydronephrosis of the right kidney has its own characteristics: its treatment by surgery is associated with the risk of damage to the pancreas.

Nephrectomy is used only in advanced cases, when the kidney has completely lost its function, and its preservation can lead to inflammatory complications.

Advice: if the doctor offers surgical treatment, you should not refuse it. The earlier the operation is performed, the better the prognosis. Full recovery is possible at an early stage.

Hydronephrosis is a serious disease, but timely diagnosis and treatment can restore or improve health. The effectiveness of treatment depends on the stage of the disease.

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Classification, types, severity

Experts divide renal hydronephrosis into types according to various characteristics. Among urologists, the classification according to ICD 10 is adopted (this is the abbreviation of the international classifier of diseases, which is also adopted in Russia and is updated every 10 years).

According to this classification, kidney hydronephrosis is primarily divided into congenital and acquired ailments. So, a disease that was laid in the prenatal period is assigned the code Q62.0 according to ICD 10.

Code No. 13 according to ICD 10 has renal hydronephrosis with dysfunction of the pelvis and ureter. There are also hydronephrosis of the left kidney and hydronephrosis of the right kidney with a narrowing of the ureter. This is # 13.1.

And hydronephrosis at number 13.2 is an ailment that arose as a result of urolithiasis.

Congenital hydronephrosis can occur both as a result of violations in the development of the fetus even at the intrauterine stage, and due to various chromosomal malfunctions. However, a hereditary factor can lead to the development of this ailment at any age. Acquired hydronephrosis also develops as a complication after a number of diseases and due to other pathogenic factors. It is noticed that at the age from 20 to 60 years, the disease more often affects women, in old age, men are more sick, on the contrary.

And yet such a division - into primary and secondary - cannot be called complete. Pathology is classified according to other criteria. So, both hydronephrotic transformation of two kidneys and one - hydronephrosis of the right kidney or the left kidney are distinguished. Bilateral hydronephrosis is a rather rare phenomenon, it is observed in no more than 9% of all cases of the disease.

Urologists also distinguish hydronephrosis according to the degree of the disease. It can be acute or chronic. If the patient has acute hydronephrosis, treatment started on time can lead to the restoration of the full functioning of the kidneys. In the chronic stage, some kidney function is lost forever. And yet, with proper treatment, it is possible to provide the patient with a normal quality of life.

Hydronephrosis is also classified according to the type of development. If the disease is complicated by an attached infection, then it proceeds according to the infected type. If not, such a disease proceeds aseptically, the symptoms in these two cases will be slightly different.

It should be noted that hydronephrosis has several degrees of severity:

1. Hydronephrosis of the 1st degree. It can run fairly easily. The patient sometimes does not notice the symptoms or they are not very pronounced. However, the renal pelvis (or pelvis) is already slightly stretched, the kidney is enlarged, although it serves its purpose. At this stage, a little more than 10 ml of liquid accumulates in it.
2. Hydronephrosis of the 2nd degree. It is characterized by further expansion of both the renal cups and the pelvis. The tissues become thinner under the pressure of excess fluid, the kidney atrophies and performs much worse with its functions. However, it is still possible, by tracking the symptoms in time, to correct the situation.
3. Hydronephrosis grade 3. It is considered irreversible. As a result of such a neglected pathology, the death of the kidney inevitably occurs.

Hydronephrosis reasons

Congenital hydronephrosis appears for various reasons, including such as:

• the presence of dyskinesia of the urinary tract;
• abnormal location of the kidney arteries, which press on the ureter;
• incorrect position of the ureter in relation to the vena cava (behind);
• congenital structures, urinary tract obstruction, ureteral valves.

Acquired hydronephrosis can develop in the presence of various urological diseases. Moreover, the causes of hydronephrosis in men and women are usually different.

So, in the stronger sex, hydronephrosis most often occurs as a result of:

• prostate tumors are usually benign;
• prostate cancer.

Women, as a rule, suffer from hydronephrosis as a result of:

• pressure of the uterus increased during pregnancy on the ureters;
• cancer of the uterus, ovaries, or cervix (the tumor presses on the ureters);
• malignant tumor of the kidney or bladder.

There are also causes of hydronephrosis, which are much less common:

One of the main signs of hydronephrosis is that the patency of the urinary tract is impaired. It occurs as a result of anatomical obstructions. They are divided into 5 different groups:

• located in the urethra or bladder;
• located at the same level as the ureter (not in its lumen);
• caused by the kink of the ureters or their incorrect position;
• located in the lumen of the renal pelvis or ureter;
• localized in the walls of the pelvis or ureter.

Symptoms of pathology

As mentioned above, hydronephrosis is dangerous, including the fact that its symptoms in the initial stage (in the so-called first period) are not expressed. Experienced doctors carefully collect anamnesis, including specifying how the patient sleeps. Often with hydronephrosis, the patient prefers to sleep on his stomach - this makes the outflow of fluid easier.

It is especially difficult to identify hydronephrosis in children - it happens that symptoms do not appear either in the first or even in the second stage. The complexity of diagnosis also lies in the fact that the disease manifests itself in different ways, depending not only on the stage, but also on the type of pathology, its nature, course.

So, for example, acute hydronephrosis is characterized by the following symptoms:

• severe pain in the side or back;
• nausea and vomiting;
• increased pain after drinking fluids;
• the manifestation of pain on the side where the kidney is affected (or on both, if both are affected);
• sometimes the pain goes to the vagina (women) or testicles (men);
• if the urine is infected, fever, chills develop;
• if there are kidney stones, there may be blood in the urine;
• in severe cases, the kidneys are enlarged, this can be determined by touch.

In the case of chronic hydronephrosis, the symptoms may be as follows:

• the same as in acute;
• do not appear at all;
• back pain that comes and goes;
• rare compared to usual urination.

If we talk about the symptoms of unilateral hydronephrosis, then they can include constant fatigue, discomfort in the lumbar region, which over time turns into aching pain, which increases with increasing physical activity or taking a significant amount of fluid. There is also a clear decrease in performance, edema.

Sometimes the patient's blood pressure rises. If the outflow of urine is seriously disturbed, the person is nauseous and even vomits, the pain becomes paroxysmal, as with renal colic, blood appears in the urine. Then we are talking about the second period of development of hydronephrosis, when the clinical picture is clear. At this stage, dyspepsia often occurs, which sometimes interferes with the correct diagnosis of hydronephrosis, especially in young children.

Symptoms in bilateral hydronephrosis are more pronounced, because kidney dysfunction is increasing, azothermia occurs, that is, an increase in the amount of nitrogen in the blood. This threatens renal failure.

If the disease is complicated by infection, purulent pyelonephritis has developed (this happens), chills, fever occur.

Diagnosis of the disease

The doctor prescribes treatment for hydronephrosis of the kidney only after an accurate diagnosis. This requires a complete examination. In the process of physical examination (that is, palpation, auscultation and percussion), little can be found out, therefore, after the initial examination and collection of anamnesis, a number of studies are usually prescribed.

There are also many additional methods by which pathology is detected. But they are not that common. The expediency of using one or another individually or many in a complex is determined by the attending physician.

Treatment methods for hydronephrotic transformation

The goal of hydronephrosis treatment is to:

• remove accumulated urine and reduce the pressure it exerts on the kidneys;
• prevent irreversible deformation;
• eliminate the cause that caused hydronephrosis.

Usually, with severe hydronephrosis, conservative therapy is ineffective, therefore it is used only at the initial stage of the disease and is symptomatic. That is, the patient is given painkillers, anti-inflammatory drugs, lowers blood pressure, with the help of antibiotics they fight bacteria in case of infection, etc. In addition, in the presence of urolithiasis (urolithiasis), oral alkalinization therapy is prescribed, and with retroperitoneal fibrosis, steroids are prescribed.

It is believed that in young children, especially under one year old, the disease in the initial stage can go away after the symptoms have been removed. Therefore, doctors rarely immediately prescribe surgery to a child with hydronephrosis. Usually, the baby is observed throughout the year, often the ailment does not require surgical intervention and disappears on its own. Urgent surgery is indicated only in the third stage of hydronephrosis in children.

Adults, as a rule, after relief of symptoms begin to prepare for surgery. And usually the doctor uses a combination of different methods.

Urine diversion

It must be carried out both in the case when the patient is being prepared for the operation, and if so far they have decided to do without it. A catheter is inserted into the bladder through which fluid flows out, thereby relieving pressure on the kidneys.

Operative intervention

Treatment for the cause begins when the pressure on the kidneys is relieved. The doctor will usually remove the cause of the fluid blockage. For example, if the ureter is blocked, a stent, a thin tube that allows urine to bypass the blocked area, is placed in it.

Then the urological surgeon begins to treat the main cause of hydronephrosis. For instance:

• kidney stones are broken with a laser or ultrasound;
• the prostate tumor is removed, often with part of the gland itself or the entire prostate;
• malignant tumors are treated with removal, chemotherapy, radiation therapy.

In a word, the main essence of the operation is to get rid of the cause of hydronephrosis. The surgeon removes the obstacle that disrupts the physiological outflow of urine, in some cases performs plastic surgery of the pelvis, restores its size.

The attending physician chooses the surgical method depending on the severity of the disease, its stage, taking into account all the circumstances. Now doctors often use not abdominal operations, and more gentle methods are endoscopic. The surgeon makes only two small punctures, inserts the endoscope and monitors the progress of the operation on the monitor.

This method is bloodless, low-traumatic, almost does not threaten postoperative complications. However, if the pelvis is too large or there are other problems, endoscopy is not indicated, it is ineffective.

It is also possible to treat hydronephrosis with the help of laparoscopy - this is also a low-traumatic method, which, at the same time, allows resection of the pathological part of the ureter.

In cases where hydronephrosis is neglected and has passed into the third stage, the so-called thermal, the kidney almost inevitably dies, and it must be urgently removed. Such an operation is called nephrectomy, it is more expedient to do it at an earlier stage, when the kidney has not yet failed and the inflammatory process has not begun. Practice shows that most often elderly patients undergo nephrectomy.

Drug treatment

As in most cases, you need to remember about vitamins, and especially about vitamin C. True, it is generally accepted that it is found in excess in lemons, however, as a rule, it remains in fruits no more than 2 months after collection, after which is destroyed. Cherries and black currants are much better, as they are able to preserve this valuable vitamin even when frozen. In addition, these fruits contain about 10 times more vitamin C than lemons. You can also take tablet vitamins, for example, such as "Ascorutin".

To strengthen the renal vessels, doctors recommend eating foods rich in L-arginine. It is an amino acid that is rich in pumpkin seeds, walnuts, and pine nuts, for example. However, in order to replenish it in the body, it will be necessary to eat almost a kilogram of nuts or seeds per day, which is certainly impossible. In this case, experts recommend using a special drug called L-Arginine. You can also take Trental instead.

If a patient has experienced jumps in blood pressure during the course of the disease, in no case should antihypertensive drugs be immediately canceled and taken in small doses for another six months. This will prevent the formation of ischemia in the kidneys. In addition, a doctor can prescribe a course of treatment with the following drugs: "Kanefron", "Cyston", "Rovatinex".

Diet and nutrition

For each case of hydronephrosis, the diet will be special depending on the degree of the disease, its nature and the cause of the disease. What kind of diet to prescribe for hydronephrosis is decided by the attending physician. But there are also some general rules:

• liquid should be consumed in moderation, no more than 2 liters per day;
• reduce salt intake in the diet - no more than 2 g per day, and it is better to completely remove it from the menu;
• you should eat more vegetables, especially fresh;
• remove legumes, fatty meat, coffee, chocolate, sausage, all smoked, sea fish from the diet.

Summary: Hydronephrosis is an ailment characterized by edema of the kidneys and a violation of the normal outflow of urine from them into the bladder. A hydroureter is swelling of the canal that connects the kidney and the bladder (ureter). Obstruction is a blockage, obstruction. It can occur anywhere in the ureter, at any level.

Hydronephrosis can be unilateral (only one kidney is affected) or bilateral (both kidneys are affected). The disease can cause an increase in blood pressure. If it is not lowered in a timely manner, kidney function will be compromised. The symptoms of hydronephrotic transformation differ depending on whether the swelling occurs immediately or gradually. In acute cases, the patient experiences severe pain, he is sick and vomits.

Treatment for hydronephrosis and hydroureter is aimed at restoring the outflow of urine from a diseased kidney.

Preventive measures

Since there are no special preventive measures for this disease, it is necessary to prevent the possibility of the occurrence and formation in the kidneys of any inflammatory processes... This requires:

• visit a urologist at least a couple of times a year;
• monitor nutrition, lead a healthy lifestyle with regular physical activity, limit the intake of salt and salty foods;
• prevent hypothermia of the body;
• promptly treat any emerging infections of the genitourinary system.

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Causes of congenital and acquired pathology

There are many reasons for the development of the disease that prevent the normal flow of urine. Among them, there are two main groups: congenital and acquired causes of pathology in children and adults.

Congenital hydronephrosis can be caused by the following factors and conditions:

• obstruction of the lower urinary tract;
• dyskinesia of the urinary tract;
• anomalies in the development of the renal artery and its branches;
• retrocaval placement of the ureters;
• congenital strictures;
• congenital valves, diverticula and spurs;
• ureterocele;
• neuromuscular segmental dysplasia;
• ectopia of the ureter.

Causes of acquired renal hydronephrosis may include:

• trauma, swelling, inflammation of the urinary tract;
• urolithiasis disease;
• tumors and metastases in the prostate gland, urinary tract, cervix, retroperitoneal space, small pelvis, lymph node involvement;
• traumatic lesion of the spinal cord with impaired conduction;
• postoperative cicatricial narrowing of the urinary tract;
• cystitis, tuberculosis.

One of the frequent congenital causes disease (20-40% of cases) is an additional vessel extending from the renal artery to the lower pole of the kidney and pressing on the ureter at the site of its discharge from the pelvis. In addition to compression, the vessel affects the ureteral zone pulse wave... In the region of constant pressure and interaction, a local inflammatory response, the formation of fibrous tissue, narrowing the lumen and provoking kinks, aggravating the violation of the outflow of urine. In addition to the artery, there may be additional venous vessels of the kidney and seminiferous tubules.

An important role in the development of the disease is played by the mobility of the kidney, the nature of the parapelvic tissue (fiber), renal blood flow, and the diameter of the blood supply vessels.

If there is hydronephrosis, only a urological doctor will find the reasons for it.

Bilateral hydronephrosis - risk of renal failure

Bilateral hydronephrosis is less common than unilateral and is associated with a deterioration in the outflow of urine at the level of the lower urinary organs (bladder, urethra) or a systemic disorder, for example, with functional impairment of ureteral motility.

Usually, bilateral hydronephrosis occurs in the presence of stones in the bladder, tumors, inflammation of the bladder, prostate gland, external pressure. At the same time, there is a greater risk of renal failure.

The development of pathology in children

Hydronephrosis of the kidney in children appears as a result of congenital anomalies and pathologies. Even on ultrasound screening of the mother during pregnancy, it is possible to detect renal hydronephrosis in the fetus. In most cases, these are mild or moderately severe changes that require dynamic monitoring and can go away on their own after the birth of the child.

The causes of the development of pathology in utero are most often anomalies in the development of the ureter (ureterocele, strictures at the junction with the bladder and renal pelvis).

In severe cases of the disease, with a threat to the life of the fetus, the method of fetal (intrauterine intervention) is known. Under ultrasound control, a drainage (tube) is carried out through the maternal abdomen into the fetal bladder for free flow of urine into the amniotic cavity. This does not cure the fetus from the disease, but it can reduce the manifestations of hydronephrosis and preserve life until birth.

Hydronephrosis in newborns can also occur in different ways. In some cases, dynamic observation and ultrasound control are sufficient several times a year, in severe cases, surgical intervention is possible - pyeloplasty, which removes strictures from the uretero-pelvic segment.

The degree of hydronephrosis and their characteristics

There are three (in some cases four) degrees or stages of hydronephrosis, which may differ in clinical manifestations and prognosis for the patient's later life. Their proposed characteristics will make it possible to give a short-term prognosis for the patient's life.

Hydronephrosis of the 1st degree is the initial stage of the disease, when the expansion of the pelvis and calyces is insignificant and does not cause deterioration of the kidney. At this stage, the increased hydrostatic pressure is restrained by the elastic wall of the hollow formations. Patients, however, usually do not show typical complaints and the diagnosis is established as a coincidence in the diagnosis of other health problems.

Over time, the pelvis and calyx gradually expand, the elastic wall becomes thinner and the disease enters the second stage.

For the 2nd degree of hydronephrosis of the kidney, symptoms such as hydrocalicosis (expansion of the calyx) and pyelectasis (expansion of the pelvis) are characteristic. A significantly enlarged pelvis causes the renal parenchyma to be pressed against the dense renal capsule, as a result of which the renal tissue becomes thinner and atrophies.

Hydronephrosis of the 3rd degree is characterized by pronounced disorders of urination and urination. The renal tissue is prone to gross atrophy and gross dysfunctions. Hydrocalicosis and pyeloectasia are increasing.

Some sources separately describe the fourth (terminal) stage of hydronephrosis, which is characterized by a complete cessation of the urinary function of the kidney. The degree of the disease can be reliably established only after passing the necessary laboratory and instrumental diagnostics.

Hydronephrosis of the kidney during pregnancy

Hydronephrosis of the kidney during pregnancy can be unilateral or bilateral. With a unilateral disease, dropsy of the left kidney most often develops (70%), less often - the right one.

During pregnancy, the development of hydronephrosis is mainly due to the pressure of the enlarging uterus on the ureters. In this case, contributing factors in the appearance of dropsy are urinary tract infections, chronic cystitis, pyelonephritis, kidney stones, vascular anomalies, as well as severe pregnancy, constipation.

Hydronephrosis in itself does not pose a threat to pregnancy and fetus, but it can lead to severe complications from the kidneys. Therefore, if symptoms of the disease appear, you must immediately visit a doctor and undergo a course of treatment in order to maintain the pregnancy.

Strong drugs are contraindicated during pregnancy, therefore, treatment at the initial stage of the disease will include phytopreparations, B vitamins, combating constipation, a kidney-sparing diet - excluding salty, fatty, fried, preservatives.

In severe cases of hydronephrosis with infection, surgery is possible.

Clinical symptoms of hydronephrosis and secondary signs

The clinical symptoms of hydronephrosis are not specific and coincide with the manifestations of diseases of the kidneys and urinary organs. Often, doctors in the initial diagnosis pay attention to secondary signs that indicate the presence of renal failure.

Hydronephrosis of the 2nd degree causes the manifestation of symptoms of the disease, and in the initial stage, dropsy is asymptomatic.

So in the presence of obstruction, inflammation in the renal pelvis, there are constant or periodic pain in the lower back of a aching, dull nature, heaviness and pain in the abdominal cavity and small pelvis and along the ureters, in the presence of cystitis - pain in the lower abdomen and cramps during urination. Pain sensations can increase with physical fatigue, body position on the back, intake of large amounts of fluid.

Usually patients with hydronephrosis take a forced position of the body - they lie on their stomach. In this position, urine flows better and painful sensations decrease.

Often with stagnation in the urinary system, an infection joins. In this case, there will be an increased body temperature, chills, general weakness, malaise.

In the case of acute ureteral obstruction with a stone, patients experience intense pain like renal colic, nausea and vomiting. With the transition of the painful process to the kidneys, patients may experience a transient increase in blood pressure, deteriorate indicators of azotemia in the blood, and increase signs of uremic intoxication.

Clinical diagnostics

Clinical diagnosis of dropsy of the kidneys is carried out on an individual basis, may include many diagnostic methods: ultrasound, dopplerography, excretory radiography, retrograde ureteropyelography, MRI, selective angiography, etc. These research methods help to determine organic disorders in organs, but do not show functional ones. Therefore, all patients with suspected dropsy of the kidneys are prescribed various functional urinary tests (Reberg's test, urine analysis according to Nechiporenko and Zemnitsky), biochemical blood tests.

When examining a patient with pronounced changes, the doctor will be able to feel a volumetric formation in the lumbar region - an enlarged kidney.

Surgery for the treatment of hydronephrosis and the condition after it

The main goal of hydronephrosis treatment is to eliminate the cause of the disease. And this can only be done by operational means. Isolated conservative therapy, as a rule, gives a short and unstable result and is used before and after surgery for hydronephrosis. In this case, antibiotics, analgesics and NSAIDs, beta2adrenomimetics to relax the urinary tract, and drugs that improve blood flow are usually prescribed.

There are many methods of surgical intervention for hydronephrosis. The choice of one of them depends on the cause of the nature and localization of the cause of the disease, the severity of its course, individual characteristics and renal function.

Operations for hydronephrosis of the kidney are performed by certified urologists in private and public medical centers. The classic treatment option for renal hydronephrosis is the Andersen-Hines open surgery. It consists in the removal of the ureter affected by sclerosis with the imposition of anastamosis with the PCS. In some cases of vascular anomalies, resection of the lower renal segment is applied to the accessory vessel. Complete removal of the kidney is performed when it completely stops working.

The patient's condition after surgery for hydronephrosis of the kidney requires no less observation than before surgery, since there is a risk infectious complications or the development of interstitial nephritis in a resected kidney. There are also several tactics for managing patients after surgery - with and without urinary drainage. In individual cases, a stent is installed in the ureter to maintain the lumen of the organ in the required volume for the period of healing of the anastamosis.

In any case, only a specialist using modern methods diagnosis, will be able to resolve the issue of choosing the optimal treatment for dropsy of the kidneys.

Do I need a diet for hydronephrosis

A diet for hydronephrosis aims to reduce the functional load on the kidneys, improve parenchyma trophism and replenish or prevent nutritional deficiencies. Whether a diet is needed and whether it is worth following is a rather stupid question, since the duration and quality of his life depends on the patient's subsequent diet.

At the same time, the intake of sodium salt is limited to several grams per day, the use of liquid is limited to the volume of fluid loss in the previous day, plus half a liter. It is recommended to replenish losses with diluted juice, table alkaline water, compotes. Canned food, fried food, fatty, spicy, smoked foods are removed from the diet. Fasting days are also prescribed to patients.

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Etiology

Initially, it is worth noting that there is a distinction between congenital hydronephrosis and acquired. Congenital hydronephrosis can result from the following factors:

• obstruction of the urinary tract;
• wrong channel location.

As for the acquired form of this kidney disease, then, as a rule, it can develop against the background of such diseases:

• inflammatory processes in the genitourinary tract;
• urolithiasis disease;
• tumors of the uterus, urinary tract, prostate and ovaries;
• metastases, malignant processes in the abdominal cavity;
• spinal cord injuries that interfere with the natural flow of urine.

In addition, disturbances in the natural outflow of urine may be due to anatomical features.

Development stages

There are three stages of hydronephrosis of the left (right) kidney:

• compensated stage - at this stage, urine accumulates in the pelvic system in a small amount. Kidney functions are almost fully preserved.
• hydronephrosis of the 2nd degree - there is a strong thinning of the tissue, which leads to a decrease in the efficiency of the organ by 40%;
• the third stage - the organ is almost completely unable to cope with its functions, chronic renal failure occurs.

Symptoms

At an early stage of the development of the disease, there are practically no symptoms. In some cases, the patient may complain of the following symptoms:

• colic;
• more frequent urination, which does not bring adequate relief;
• feeling of heaviness in the area of \u200b\u200bthe organ.

As congenital or acquired hydronephrosis develops, a dull, aching pain in the lumbar region may be felt. The localization of pain depends on which kidney is affected. Further, you can observe the following symptoms:

• lower abdominal pain;
• weakness;
• high temperature;
• nausea;
• attacks of pain in the area of \u200b\u200bthe organs;
• bloating;
• high blood pressure.

If the patient has a fever (more than 37 o C), then this indicates the onset of an infectious process, especially when there is a suspicion of hydronephrosis in children.

In some cases, the patient does not have the above symptoms, except for one - urine mixed with blood. Such a violation requires immediate medical examination.

Hydronephrosis of the left kidney

Hydronephrosis of the left kidney is one of the most common diseases of the genitourinary system. The main trigger is a stone, which can block the flow of urine. Moreover, if a stone enters the urinary tract, bilateral hydronephrosis is considered.

The first and most common symptom of this disease is pain on the left side, which radiates to the leg. There is also a painful outflow of urine mixed with blood and mucus. In some cases, the patient cannot urinate, although the urge to urinate is present.

With such symptoms, you should immediately consult a doctor for an accurate diagnosis and immediate treatment. An operation is almost always prescribed.

Hydronephrosis of the right kidney

Hydronephrosis of the right kidney is a urological disease that is caused by a blockage of the urinary tract. The main risk group is the elderly and those who abuse alcohol.

Symptoms of hydronephrosis of the right kidney are the same as in the localization of the pathological process in the area of \u200b\u200bthe left kidney. The only difference is that with hydronephrosis of the right kidney, the pain radiates to the entire lower back.

Hydronephrosis in children

As a rule, hydronephrosis in children is a congenital disease. This pathology can occur in newborns if hydronephrosis is diagnosed during pregnancy. In newborns, pathology often affects both kidneys at the same time.

With the help of special diagnostics, it is possible to diagnose hydronephrosis in the fetus. Therefore, the congenital form of hydronephrosis in children is diagnosed much more often.

Hydronephrosis in the fetus and the reasons for the development of such a pathology in it can be determined even in the early lines, which makes it possible to start treatment in a timely manner, which means that it will be more effective. Such an ailment in newborns can be caused by the following factors:

• stenosis of the pelvic system;
• high discharge of the ureter;
• narrowing of the bladder neck.

Hydronephrosis in children is treated more successfully than in adults, as it is diagnosed in the early stages.

Treatment of hydronephrosis in children

Treatment of hydronephrosis in children and newborns is carried out only after accurate diagnosis and confirmation of the diagnosis. The mandatory diagnostic program includes the following:

• general analysis of urine and blood;
• Ultrasound of the kidneys;

As a rule, the treatment of hydronephrosis in children is carried out only promptly and takes place in two stages:

• excision of tissue to widen the passage;
• anastomosis - suturing the ureter to the pelvis.

Such an operation does not pose a threat to life, subject to the competence of the surgeon. The rehabilitation period does not last long, but a diet is required for this period. This circumstance does not apply to newborns.

Hydronephrosis during pregnancy

Hydronephrosis during pregnancy has the same symptoms as listed above. It should be noted that hydronephrosis in this position develops more often in the right kidney than in the left. This is because the ureter is compressed due to the enlargement of the uterus.

It is very important to determine whether this disease was formed during pregnancy or was congenital. The fact is that hydronephrosis during pregnancy can cause the development of pathology in a newborn.

Operable intervention in this position is impossible. As a rule, conservative treatment is prescribed with minimal medication consumption. In this case, treatment with folk remedies is appropriate, but only as directed by a doctor. It is important to follow the diet, but without prejudice to the child.

Diagnostics

During the examination, the doctor can pre-diagnose hydronephrosis by palpation. In the area of \u200b\u200bthe organ, compaction is observed. The patient's symptoms and general health are also taken into account. For an accurate diagnosis, instrumental and laboratory tests are prescribed:

• general analysis of urine and blood;
• Ultrasound of the kidneys;
• x-ray examination of the kidneys.

Based on the analyzes, an accurate diagnosis is made and the correct course of treatment is prescribed. If it is impossible to make an accurate diagnosis based on the results of such studies, the doctor may prescribe a CT and MRI scan.

Treatment

In most cases, an operation is prescribed. Especially if the disease is diagnosed in children.

As for the treatment of the disease in adults, both conservative treatment and surgery are used. It all depends on the degree of development of the disease and the general condition of the patient. It is important to follow a diet for the period of treatment.

Conservative treatment is appropriate only at an early stage of the development of the disease. Within the framework of therapy, drugs of such a spectrum of action are prescribed:

• pain reliever;
• anti-inflammatory;
• to lower blood pressure;
• antibacterial (if there is an infection).

However, as practice shows, even at an early stage, the operation gives the best results.

Diet

Diet is not the last place in the treatment. The diet is prescribed by the doctor individually. The following foods should be excluded from the daily diet:

• salty;
• fatty;
• smoked;
• sweets;
• alcohol;
• fried meat and spicy dishes.

Instead, the diet should include the following:

• vegetables and fruits;
• dairy products;
• proteins.

Such a diet, in combination with the right treatment, gives positive results. By the way, diet can help improve metabolism, which is beneficial for the whole body.