Hydronephrosis of the kidney is a disease in which there is a progressive expansion of the renal pelvis and calyx caused by a violation of the outflow of urine, eventually leading to atrophy of the kidney tissue and serious disturbances in the work of this organ.
Classification of kidney hydronephrosis
There are three stages in the development of the disease:
- I stage - only the renal pelvis is enlarged, the functions of the kidney are not violated, or are violated to an insignificant degree.
- II stage - the kidney is increased by 15-20% compared to the norm, the walls of the pelvis are thinned, and the muscle functions are violated. The renal function is markedly reduced (by 20-40%).
- III stage - the kidney is increased by 1.5-2 times, its function is reduced by more than 50%, up to the complete rejection of the kidney.
Depending on the severity of the lesions, the renal parenchyma distinguishes 4 degrees of the disease:
- renal parenchyma not affected;
- damage is minor;
- significant damage;
- complete atrophy of the renal parenchyma and renal failure.
Depending on whether one kidney is affected or both, one-sided and two-sided hydronephrosis is divided.
Also, depending on the cause, hydronephrosis is divided into congenital and acquired. The latter can be caused by urolithiasis, damage to the urinary tract, various tumors, dyskinesia of the urinary tract.
Symptoms of kidney hydronephrosis
Hydronephrosis can be acute and chronic.
In acute hydronephrosis, the symptoms are more pronounced and develop rather quickly. At the initial stage of the disease (when the parenchyma is not damaged yet, and the kidney function is not significantly affected), the symptoms of the disease provoking hydronephrosis are more pronounced.
The main symptom of hydronephrosis is a constant dull aching pain in the lower back, the intensity of which does not depend on the time of day. Pain can be localized in the right or left side, depending on which kidney is affected. In the early stages of the disease, pain can resemble an attack of renal colic.
Other symptoms may include:
- blood in the urine;
- frequent urge to urinate ;
- nausea and vomiting;
- increase in temperature (in case of infection on the background of hydronephrosis).
The chronic form of the disease develops more slowly and is practically asymptomatic. The patient may be disturbed by periodic dull pain in the lower back, intensifying after drinking a lot of fluid, weakness, fatigue, hypertension .
In the late stages of the disease, swelling and deformity in the lumbar region, palpable, can be observed.
Treatment of hydronephrosis
The treatment of hydronephrosis is performed exclusively by a surgical method. Conservative treatment in hydronephrosis of the kidney is ineffective and is used only to alleviate the symptoms of the disease and stabilize the patient's condition before surgery.
As an emergency, a kidney drainage is performed in such a disease, in which a urine accumulation is removed from the pelvis by means of a special needle, and thus the pressure on the kidney is lowered.
Surgical intervention in each case is individual and depends on
First of all, the operation with hydronephrosis is aimed at restoring the normal outflow of urine and removing the obstruction that caused it. If the kidney function is not significantly affected, as a rule, plastic surgery of the renal pelvis (restoration of its normal size) and ureter is performed, which allows the body to function properly in the future. In the late stages of hydronephrosis, when the kidney ceases to function, its treatment is impossible, resort to its removal, since otherwise serious inflammatory complications are possible.