Kidney hydronephrosis: what it is, what causessymptoms, treatment in adults, extent, outcome of the disease

Kidney hydronephrosis is a specific disease.
characterized by an abnormal increase in internal size
of the renal cup region due to the strong pressure on her
walls of a large volume of fluid (urine excreted by the kidneys). In this
article, you will learn what signs accompanied by pathology, how
treat kidney hydronephrosis with modern methods, what else can
to take

Kidney hydronephrosis: what is it?

что такое гидронефроз почек

What is a kidney disease like
hydronephrosis? Hydronephrotic transformation of the kidney or
renal hydronephrosis is a serious pathology consisting in
increased content in both or one kidney fluid. Is broken
normal urine flow, and this leads to inflammation of the kidney tissue –
parenchyma with its subsequent atrophy and deterioration of the filtering and
выделительной функции kidneys.

As a result of this, a partial may first arise, and then
with the progression of the disease, and complete renal

In medical practice, are found equally often as
гидронефроз правой, так и левой kidneys. As for the bilateral
hydronephrosis, it is registered in 5-9% of detected cases.
Hydronephrosis can be not only congenital, but also acquired.
Moreover, congenital hydronephrosis occurs on the background
дискинезии мочевых путей, аномалии размещения почечной артерии
(possibly its branches), which squeezes the ureter.

Causes of hydronephrosis

The disease develops due to impairment or absolute
stopping the movement of urine from the kidney to the bladder, which
occurs due to a number of physiological or anatomical factors.
 Additional renal vessel may cause disease,
passing to the bottom of the kidney from the aorta. This дополнительный сосуд
is located crosswise with the ureter and presses on it, that
leads to a narrowing.

A factor that provokes the development of kidney hydronephrosis becomes
an obstacle to the natural flow of urine from the body. This is due to
there can be any pathological process occurring as in a kidney,
and beyond – in nearby organs and tissues:

  • stricture (narrowing) of the urinary tract,
  • congenital or acquired;
  • various stones in the genitourinary system;
  • benign neoplasms;
  • malignant tumors;
  • retroperitoneal fibrosis.

As a result of urinary retention and expansion of the cups and renal pelvis
parenchyma and muscle fibers of the body atrophy. This leads to
deterioration of the kidney, until the complete loss of function.

Depending on the causes of the disease, it is distinguished

  1. Congenital – hydronephrosis develops in utero or immediately
    after birth.
  2. Acquired – hydronephrosis occurs due to lesions
    ранее здоровой kidneys.

Acquired form of hydronephrosis may have as anatomical
causes of violation of urine outflow from the renal pelvis, and
physiological (arising on the background of central and
peripheral nervous system).

In total there are five main groups of pathological conditions,
creating mechanical anatomical obstacles in
urinary system:

  • Thickening of the walls of the ureter or pelvis as a result
  • The presence of tumors in the surrounding organs and tissues that
    squeeze the ureter, kidney or urethra.
  • Violation of the normal location of the ureter or kidney
    (kidney prolapse, bending or torsion of the ureter).
  • Overlap of the inner lumen of the ureter and pelvis
    formed kidney stones.
  • Squeezing or damage to the lower urinary organs
    systems as a result of cancer and other diseases or

Quite often, women develop hydronephrosis during pregnancy.
It is caused by mechanical compression of the ureter and other
organs of the urinary system enlarged uterus.

Extent of the disease

Doctors share several degrees of development of this disease,
which have individual characteristics.

1 degree first degree hydronephrosis characteristic: slight
urine accumulation in the pelvis, a slight stretching of the walls of the pelvis,
kidney functionality is not impaired;
2 degree for the second degree of kidney hydronephrosis: due to excessive
the extension of the pelvis, the tissue of the body becomes thin and suffers
функциональность kidneys. If a гидронефроз почек имеется только в
one body, the main burden of work falls on
3 degree at the third degree of hydronephrosis note: a sick kidney
stops functioning completely, a healthy body experiences
чрезмерные нагрузки, что вызывает почечную failure. With
such signs, without proper treatment, renal hydronephrosis may
be fatal.

Soже гидронефроз классифицируют по типу развития. If a болезнь
complicated by acceding infection, it proceeds according to
infected type. If a нет, такое заболевание протекает
aseptically, the symptoms in these two cases will be somewhat

Symptoms of hydronephrosis

In the photo to the left is a healthy kidney, and to the right is hydronephrosis

In the photo to the left is a healthy kidney, and to the right is hydronephrosis

Often the development of kidney hydronephrosis occurs imperceptibly.
The disease has no specific symptoms. In the early stages
the clinical picture is due to the cause of the development
hydronephrosis. For example, when urolithiasis can occur
bouts of renal colic, characterized by severe acute pain
along the ureters.

As the pathology progresses, the patient complains about the following

  • dull back pain
  • independent of time of day and body position;
  • painful sensations are most pronounced in the area
    affected kidney: if the left side of the waist hurts, then it is affected
    left kidney and vice versa;
  • in some cases, pain appears in the right side of the abdomen;
  • often painful with nausea and

If the hydronephrosis of the kidneys is progressing
It turns out that the following symptoms of hydronephrosis appear:

  • pronounced pain from the problem kidney;
  • painful attack accompanied by nausea, in some cases –
  • blood pressure rises;
  • flatulence increases, the patient complains of discomfort due to
    abdominal distention;
  • with the penetration of infection in the kidney body temperature rises
    – the most dangerous sign;
  • there is blood in the urine – this applies to those patients who have
    who are diagnosed with urolithiasis.

Hydronephrosis of the left kidney

Hydronephrosis of the left kidney является одним из самых частых
complications of urolithiasis, which can also manifest itself and
on right. Hydronephrosis of the left kidney повышает внутреннее давление
cups and pelvis. The walls of these bodies for some time “struggling” with
high pressure. Not sustaining pressure, pressure gradually
acts on the kidney itself, which in turn prevents the excretion of urine.
This process is capable of hitting the tissues of the left kidney. Tubules and
glomeruli atrophy and shrink. As a result, the layer is reduced
organ in which the formation of urine.

The first symptoms of urinary stagnation are: acute pain in the area
side of the abdomen, extending to the foot on the affected side. If a
there is hydronephrosis of the left kidney, then the pain will give and in
back area.

Symptoms in hydronephrosis of the left kidney:

  1. pain in the kidneys, aggravated to the damaged area;
  2. nervous overexcitement, anxiety;
  3. symptoms of intoxication with nitrogenous products – loss
    appetite, dizziness, migraine, vomiting and nausea,
  4. pain in the back, which gives to the groin and under the shoulder blades;
  5. pain in the abdomen (stretching the walls of the ureter under
    the size of the stone);
  6. small amount of urine excreted per day.
  7. A small amount of mucus and blood may also appear when

When late diagnosis, as well as unqualified
treating left kidney tissue can be badly damaged. This
the process leads to partial loss of organ functionality or
even to the complete loss of the ability to perform its functions.

Hydronephrosis of the right kidney

Hydronephrosis of the right kidney необходимо лечить. If a этого не
to do, kidney failure may develop. Stop work
kidney can lead to intoxication and result in the death of the patient.
Another possible outcome is urolithiasis, which can
aggravate from infection. The most common complication in this
The case is a cup break.

Depending on the level at which the long-term
blockage, hydronephrosis of the right kidney proceeds with various
symptoms. The most common cause is urolithiasis.
Urinary stones that exceed natural size
excretory system, get stuck in places of narrowing, and therefore
completely or partially violate the outflow of urine.


Symptoms and signs:

  1. In the initial stage of the disease, the person usually complains of renal
    colic; dull pain usually occurs in the evening
    lower back which runs to the night.
  2. Attacks may be caused by exercise or general
  3. The presence of blood in the urine is observed at elevated pressure in
    cups, as well as the presence of kidney stones.
  4. Another characteristic feature is an increase in the kidney. In people with
    asthenic physique she can even be palpable through
    front wall of the abdomen.

Most cases of hydronephrosis (more than half) have
left-sided localization, in about 40% of cases pathology
affects the right kidney and only 5% of the hydronephrotic transformation
are bilateral in nature.


A dangerous complication of the hydronephrotic transformation is
renal failure and atrophy. Due to changes in tissues,
the kidney loses its functionality, and there comes a deadly
outcome from intoxication by exchange products.

Due to renal dysfunction, the blood content increases
residual nitrogen and other substances normally excreted through the kidneys with

To avoid fatal intoxication, patients indicated
removal of the affected organ, after which patients are given
hemodialysis procedures with an artificial kidney device or
transplant the organ from the donor.


During the examination, the doctor can pre-diagnose
hydronephrosis by palpation. In the area of ​​the organ is observed
compaction. Also taken into account symptoms of the patient and the general
his state of health.

Ultrasound of the kidneys with hydronephrosis

Ultrasound of the kidneys with hydronephrosis

For accurate diagnosis prescribed instrumental and
lab tests:

  • urine and blood tests;
  • Ultrasound of the kidneys;
  • X-ray examination of the kidneys.
  • If a результаты предыдущих обследований неоднозначны, пациент
    may be referred to an MRI or CT scan.

Hardware diagnostics help determine and compare, with
which side there is, or kidney damage prevails. So
hydronephrosis of the right kidney has a larger size of the pelvis region according to
compared with a healthy left kidney. Or vice versa, left hydronephrosis
the kidney has a larger pelvis compared to the right kidney.

Soже есть множество дополнительных методов, при помощи которых
revealed pathology. But they are not so common.
The expediency of applying one or another individually or many
in the complex determines the attending physician.

Treatment of renal hydronephrosis

The course of treatment, which will be selected by the doctor, has three directions:
relieving symptoms, eliminating the cause and reducing the load on
kidneys. The goal of treating hydronephrosis is to:

  • remove accumulated urine and reduce its renal impairment
  • prevent irreversible deformation;
  • eliminate the cause of hydronephrosis.

Drug treatment

Often the use of drugs precedes
the operation. Symptoms are eliminated at this stage.
hydronephrosis, urination is stimulated, side effects are removed
pathological processes, such as foci of infection.

The doctor may prescribe drugs of the following steps:

  1. painkillers – to relieve pain
  2. antibiotics – if there are signs of infection in the body;
  3. средства, понижающие артериальное pressure;
    anti-inflammatory drugs;
  4. other medicines, depending on the patient


If a состояние почки в динамике ухудшается, то необходимо
treatment of hydronephrosis with the help of surgical intervention.

There are two types of functions aimed at improving
hydronephrosis operations:

  1. creating an additional channel for urine output,
  2. сужение расширенной чашечно-лоханочной системы kidneys.

As a rule, radical surgery
предшествует дренирование kidneys. Soже они применяется для лечения
hydronephrosis in pregnancy, which is due to compression
ureter growing in size uterus.

Type of operation Brief description and features
Operation по Андерсону-Хайнсу Open surgery, performed for adults and children. Effective with
сужении участка мочеточника возле kidneys. It is carried out under the general
anesthesia. Complications наблюдаются у 10% пациентов.
Bougienage Endoscopic surgical method based
on the introduction into the ureter of special rods – bougie. Applied
to expand the ureter.
Balloon dilatation Under x-ray control, a special balloon is introduced into the ureter.
with tags. The site with the presence of a stricture, the doctor expands the supply
pressure, while the contrast agent enters the ureter.
Operation проводится эндоскопическим методом.
Endotomy Modern and most effective endoscopic method
surgery for renal hydronephrosis. Based on the application
electric current of the desired frequency, laser radiation or
�”Cold knife”.
Laparoscopic surgery Проводится под общим anesthesia. The doctor will make a 4-5 puncture (port)
in the abdominal wall. Endoscopic equipment is introduced into one;
the rest are special surgical instruments. Operation
differs in small degree of injury of fabrics, suturing,
usually not required.
Nephrectomy It is carried out in extreme cases with unilateral hydronephrosis
(lesion of left or right kidney only). Indication to remove
kidney is complete atrophy of her parenchyma.


Not the last place in the treatment is diet. Diet прописывается
doctor individually. Meals should be such as to help
restore the flow of urine and kidneys.

The following 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;
  • milk products;
  • squirrels.

Soая диета в комплексе с правильным лечением даёт положительные
results. By the way, the diet can help improve the exchange.
substances that are useful for the whole body.

How to treat hydronephrosis folk remedies

народные методы лечения

Traditional methods recommend the use of additional
to the main drug treatment after consultation with the treating
a doctor. In this case, one kidney should be healthy.

Treatment of folk remedies involves the use of various
herbs and medicinal fees that improve kidney function and
facilitate the condition of patients with hydronephrosis. For this

  1. Pumpkin, namely, the stem. For the preparation of medicines
    the stalks are crushed, filled with 500 ml of boiled water and
    insist on a water bath for 20 minutes. After this infusion
    must be removed, wrapped in a warm towel and infused for about 2
    hours Take 4 times a day for half a glass at the reception.
  2. 150 gr. birch leaves, 50 g. nettle leaves, 50 g. herbs
    adonis, 50 gr. grains of oats, 50 gr. bearberry and 50 gr. field
  3. In equal proportions take leaves of black currant, leaves
    малины, корней аира, почечного чая, herbs череды, цветков
  4. Травы при гидронефрозе применяют в виде сборов,
    It is recommended to use not longer than 3-4 months. Required
    change fees, after each course after waiting for about 2 weeks. Infusions
    plants take on an empty stomach, approximately half an hour before meals.
  5. Chopped parsley root, 1 tbsp. l., poured 100 ml
    boiling water. The remedy is infused all night. Carefully drained in the morning
    liquid and drink 1 tbsp. l on an empty stomach during the same day.
    If a нет возможности приобрести корни растения, можно использовать
    and seeds. However, they give less pronounced positive
    result. Soим же образом можно готовить настои
    при гидронефрозе из семян тмина.


Kidney hydronephrosis, if acquired, occurs only when
certain conditions. Doctors recommend sticking with the following.
preventive measures to avoid its development:

  • time to empty the bladder – frequent artificial
    retention of urine may cause its part to be
    splash back into the pelvis;
  • to limit the use of salt and water – violation of salt and
    water balance leads to excessive urine production in the kidneys;
  • avoid hypothermia – this can trigger development
    inflammatory processes in the urogenital system.

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