Hydronephrosis of the kidney
is a hydronephrosis transformation of the kidney. The disease is an expansion of the cup-and-pelvic system (which combines several renal cups that open into the renal pelvis) of the organ.
Hydronephrosis in its initial stage leads to an insignificant increase in the pressure in the renal and pelvic system, but as the disease develops, the pressure increases and, ultimately, leads to an effect on the entire organ and to damage the kidney tissue.
In hydronephrosis, the following symptoms are common: hematuria, pain and the possibility of palpating the kidney, but their combination is not sufficient to diagnose hydronephrosis (since similar symptoms are present in other diseases of the urinary system). Therefore, a complete examination, in particular, the passage of patients with ultrasound (ultrasound).
Also in medical practice, radiography of the urinary tract and intravenous urography are used to diagnose hydronephrosis transformation of the kidney and determine the degree of progression of the disease, with the help of which it is possible to assess the condition of the organ and its functionality. Significance has also the clarification of the patient’s complaints, and the data of laboratory tests.
Treatment of hydronephrosis is aimed at eliminating the causes that led to the development of this disease. Perhaps surgical treatment (conservatively hydronephrosis is treated in its initial stage) – the prognosis is usually favorable.
It is required to comply with a certain diet (the content of essential amino acids in food, consumption of berries, vegetables and fruits, limiting the addition of cooking salt, etc.) to patients with hydronephrosis.
Hydronephrosis of the kidney is an enlargement of the renal calyces and pelvis.
In a generalized language, the kidney functions as follows: the urine accumulates continuously in the tissues of this organ, which collects into the calyxal and pelvic system of the kidney, and then enters the ureter that opens into the bladder. With hydronephrosis, urine accumulates in the above system in large quantities, as a result of which expansion occurs.
Hydronephrosis is a polyethiologic disease.
This means that many reasons can influence the development of hydronephrosis. All of them are united according to the principle that lead to hydronephrosis of the kidney.
Impairment of urine outflow is a prerequisite for the development of kidney hydronephrosis.
This is so. An obstruction to urinary outflow may, for example, be anomalies of the development of the urinary tract, urolithiasis, damage to the urinary tract due to trauma, etc.
Hydronephrosis is divided into primary and secondary.
The cause of primary hydronephrosis, or, as it is called, congenital, is an abnormality of the development of the renal tissue or urinary tract. An innate form of the disease can also occur with the condition of available additional blood vessels.
Secondary hydronephrosis can develop as a result of tumors of the ureter, kidney, and renal pelvis. Also, the reasons for the onset of hydronephrosis transformation of the kidney (hydronephrosis) include urolithiasis (which, nevertheless, is capable not only of causing the disease, but also its consequence) and the consequences of injuries.
The onset of hydronephrosis is marked by an increase in urine pressure in the calyx and pelvis of the kidney.
The consequence of this increase in pressure is the development of muscle and elastic fibers in stretchable structures (in the renal and pelvic renal system).
The first time due to the developed elasticity with increased pressure, the renal-tubular system successfully fights and counteracts it, but to a certain degree of its increase. With the development of hydronephrosis, the pressure tends to increase more and more, so it starts to act not only on the calyx and pelvis of the kidney, but also on it, thereby making it difficult to drain the urine out of the organ.
If such a situation persists for a long period of time, the disease can cause damage to the kidney tissue, resulting in kidney tubules and glomeruli not being insured against atrophy – they wrinkle, thereby reducing the layer of the organ in which primary and secondary urine is formed.
If the cause of human hydronephrosis is not clear and, accordingly, is not eliminated, the lesion continues and leads to a thinning of the kidney tissue. In this case, the calyx of the organ and pelvis reach enormous sizes, the action of gravity often leads to the fact that the kidney can not be kept in its own bed – it goes down.
Hydronephrosis leads to the development of renal failure.
This is inevitable if the disease in time is not detectable and does not eliminate the cause that caused its occurrence. If hydronephrosis is started, then it threatens even that the kidney completely ceases to work, death may occur, since substances from the human body will cease to be excreted, which are normally excreted in the urine, that is, the body’s intoxication with metabolic products.
Hydronephrosis can lead to the development of urolithiasis.
As noted earlier, urolithiasis can be both a cause of hydronephrosis and its consequence. Urolithiasis as a consequence of hydronephrosis transformation of the kidney can aggravate the course of hydronephrosis. To urolithiasis (as a result of which the normal discharge of urine is also disturbed) pyelonephritis, an inflammation of the renal tissue, can also join. To a very serious and dangerous complication of hydronephrosis transformation of the kidney is an unexpected rupture of the calyx or pelvis of the kidney, as a result of which urine enters directly into the retroperitoneal space.
The manifestations of hydronephrosis transformation of the kidney are numerous.
This is due to a variety of reasons that can lead to the development of hydronephrosis. However, we can distinguish three main symptoms of this disease, which are most often encountered in the presence of hydronephrosis. These include the following: the possibility of probing to determine the kidney, the appearance of pain and hematuria.
Hydronephrosis transformation of the kidney can give different pains.
If it is a question of the very beginning of the disease, non-frequent manifestations of hydronephrosis are recurrent renal colic. Their periodic appearance is associated with pressure spikes in the cup-and-pelvic system. Renal colic may occur when the stones move in the event that the hydronephrosis transformation of the organ is accompanied by urolithiasis. And the arising pain can have very expressed character.
In the region of the waist and abdomen with hydronephrosis, dull pain often occurs. Toward evening, the pain may tend to increase noticeably, but at night the intensity of the pain syndrome decreases. In addition, an attack of pain can occur immediately after the physical exertion on the patient’s body.
It is known that as the disease progresses, the pain that occurs is less and less pronounced. Often they give, and if to speak more scientifically, they irradiate, into the lower limb and groin.
Hematuria is a characteristic feature in hydronephrosis transformation of the kidney.
Actually, hematuria is a condition where blood elements are found in the patient’s urine. The cause of hematuria in the case of hydronephrosis is strongly different from the normal (upward) pressure in the calyxal and pelvic system of the kidney, as well as the irritation of the kidney tissue. Hematuria can also be observed during the movement of stones (if any), and microtrauma. In addition, hematuria itself can provoke the formation of stones, that is, urolithiasis.
The possibility of palpation of the kidney is characteristic of the hydronephrosis transformation of the kidney.
It is important to understand that the kidney is greatly increased due to the increase in its constituent parts – cups and pelvis.However, the kidney can not be felt through the abdominal wall. Basically, this symptom occurs in people who have a lean physique, but in the case of a very large increase in the kidney it can be felt by people who are not very thin.
Pain, hematuria and the possibility of palpation of the kidney are symptoms that are not sufficient to diagnose hydronephrosis.
The reason for this is simple – these symptoms are often expressed in other diseases, that is, they are not characteristic only of hydronephrosis transformation of the kidney. In this regard, to diagnose hydronephrosis, it is necessary to inspect the patient and conduct laboratory and instrumental studies. Based on their data, a correct diagnosis can be made.
Passage of ultrasound examination is an obligatory stage in the diagnosis of hydronephrosis.
Ultrasound (ultrasound) is not only a simple method of obtaining important data on the kidney condition, but also a reliable method. The presence of stones and the size of the kidney allows you to evaluate the survey radiography of the urinary tract.
Intravenous urography allows you to evaluate the functionality of the kidney.
This is very important for clarifying the presence of hydronephrosis and the degree of its progression, since ultrasound and radiographic data are often not enough to compile a complete picture of the disease.
Intravenous urography is carried out as follows: a nutrient is injected into the body of the patient with a certain substance. It accumulates in the kidneys, after which it is excreted along with the urine. The essence of this method is that the specialist, after a certain period of time after the introduction of the substance, takes pictures. These images allow us to judge the degree of damage to the kidney tissue.
In the treatment of hydronephrosis transformation of the kidney it is necessary to eliminate the cause that caused the development of the disease.
This is an important and main stage in treatment, which determines its effectiveness. If a kidney stone disease has led to hydronephrosis, then the treatment will consist in getting rid of this illness. It can be a crushing of stones or surgical treatment (removal of stones).
Hydronephrosis is treated with surgical intervention.
In modern medicine, several methods are known to get rid of this disease. Thus, with hydronephrosis transformation of the kidney, several types of surgery are possible. First, this is the fulfillment of an anastomosis between the pelvis and the ureter, the essence of this operation is to create an additional pathway for the outflow of urine from the kidney. As a result, an objective prerequisite is created for the normalization of pressure in the calyx and the renal pelvis.
The second possible operation in hydronephrosis is associated with the elimination of constriction of the calyx-pelvis complex – longitudinal dissection of tissues and their cross-linking are carried out. Stitching is already done in the transverse direction. Thus, one of the quite frequent causes leading to hydronephrosis transformation of the organ is eliminated.
The moment of surgical treatment is important: the earlier the corresponding operation is performed, the sooner the recovery and the more likely the restoration of kidney functions.
One of the goals of surgical treatment is to prevent the spread of infection and the development of renal failure. The forecast is usually favorable.
Hydronephrosis can be successfully cured by conservative methods.
Unfortunately, they can be dispensed with only at the initial stages of the disease, when hydronephrosis has not yet created problems with impaired human capacity and did not lead to a sharp decrease in the functionality of the kidney. Therefore, if there are signs of hydronephrosis transformation of the kidney, an early hospitalization and examination is necessary.
Hydronephrosis requires a certain diet.
The patient should consume a lot of fresh fruits and vegetables. In a day, the patient is recommended to drink at least two liters of liquid.In addition, the food included in the diet should be high-calorie (daily requirement is approximately three thousand kilocalories). Food should include essential amino acids (amino acids that can not be synthesized in the human body, but must enter it in ready form) – in this regard, it is recommended that the potato-egg diet is followed. It is necessary to limit the amount of salt added to food.