Pronounced: high-drow nef-row-sis
En Espaol (Spanish Version)Definition
Hydronephrosis occurs when urine builds up in the kidneys and cannot drain out to the bladder. The kidneys swell from the excess urine. The condition may affect one kidney or both. Hydronephrosis is not a disease itself, but rather a sign of another disease or condition affecting the kidneys. Swelling of the kidneys can lead to kidney damage.
This is a serious condition that requires care from your doctor. Most patients who have hydronephrosis will not know it until it has already damaged the kidney. Therefore, if you are at risk for this condition, it is important to be under the care of a physician.
Causes
Kidney, Ureter, Bladder, and Kidney Stone
2008 Nucleus Medical Art, Inc.
Hydronephrosis is caused by two problems in the urinary system. A blockage may prevent urine from draining out of the kidneys. Or a condition called reflux may cause urine to flow back into the kidneys from the bladder.
Conditions that may cause hydronephrosis include:
- A blockage or defect in the urinary system that is present at birth
- Kidney stones
- A blood clot
- Scarring of the ureters (tubes that connect the kidneys to the bladder)
- A tumor in the pelvic area (such as bladder, cervix, colon, or prostate)
- Enlarged prostate
- Enlarged uterus during pregnancy
- Persistent urinary infection in the kidneys
- Neurogenic bladder
- Injury to structures in the urinary system (eg, from surgery or trauma)
Risk Factors
The following factors increase your chances of developing hydronephrosis:
Defect in the urinary system that is present at birthCancers in the pelvic area Pelvic surgeryBlood-clotting disordersRecurrent urinary tract infectionsEnlarged prostateNeurogenic bladderPregnancy SymptomsHydronephrosis may or may not cause any symptoms.If symptoms occur, they may include:Pain in the back, waist, lower abdomen, or groinPersistent pain with urination or urinary frequency (from urinary tract infections)Increased urge to urinate or urinary incontinenceDribbling after urinationFeverNausea and vomitingUnexplained itching DiagnosisYour doctor will ask about your symptoms and medical history, and perform a physical exam, which may involve examination of the pelvis or rectum to feel for blockages. You will likely be referred to a urologist and/or nephrologist for further diagnosis and treatment. Tests may include: Urine teststo check for blood, protein, bacteria, or other evidence of damage to the kidneysBlood teststo check for evidence of damage to the kidneysBladder catheterizationa thin tube, called a catheter, inserted into the bladder to try to drain itAbdominal ultrasound a test that uses sound waves to examine the structures in the abdomen (in this case the kidneys, ureters, and bladder) Intravenous urogram (or pyelogram)an x-ray test that uses contrast dye to assess the structure and function of the kidneys, bladder, and ureters (may not be used if kidneys are damaged)Computed tomography angiography (CTA) a type of x-ray that uses a computer to make pictures of the kidneys, bladder, and ureters Magnetic resonance imaging(MRI scan) a test that uses magnetic waves to make pictures of the kidneys, bladder, and ureters Cystoscopy a thin, lighted tube inserted through the urethra and into the bladder to examine the lining Voiding cystourethrogramx-rays of the bladder and urethra taken during urination after contrast dye is placed in the bladder Treatment Treatment involves:
Draining excess urine from the kidneyRemoving the blockageTreating conditions that cause blockage or refluxTreating infections in the urinary system Some causes of hydronephrosis resolve without treatment (such as pregnancy and kidney stones ). Treatment options include: Antibiotics to treat urinary tract infectionsMedications (eg, anticholinergic drugs) to treat neurogenic bladderCatheter inserted into the bladder to drain the urineNephrostomy (a tube inserted into an opening in the midsection to drain urine from the kidney)Surgery to remove a blockage or correct a defect in the urinary systemSurgery to remove part or all of the kidney (rare) Babies born with conditions that cause hydronephrosis are monitored to see if they will need treatment. Care of such babies involves: Regular visits to the doctorA special doctor who treats children with inborn urinary problemsAntibiotics to treat urinary tract infectionsPossible surgery to correct the problem Prevention In general, the causes of hydronephrosis cannot be prevented. Prompt treatment of conditions that cause hydronephrosis reduces the risk of complications, such as kidney failure .
RESOURCES: American Kidney Fundhttp://www.akfinc.org American Urological Associationhttp://www.urologyhealth.org National Kidney Foundationhttp://www.kidney.org Urology Healthhttp://UrologyHealth.org CANADIAN RESOURCES: BC Childrens Hospitalhttp://www.bcchildrens.ca BC Health Guidehttp://www.bchealthguide.org The Kidney Foundation of Canadahttp://www.kidney.ca References: Hydronephrosis. Mayo Foundation for Medical Education and Research website. Available at: http://www.mayoclinic.com/invoke.cfm?id=AN00829 . Accessed August 18, 2005. Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL, eds. Harrisons Principles of Internal Medicine . 16th ed. New York: McGraw Hill; 2005. Kidney disease and kidney failure. National Kidney and Urologic Disease Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/topics/failure.asp . Accessed August 18, 2005. Your child has hydronephrosis. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozPrint.cfm?id=151# . Accessed August 24, 2005. Last reviewed January 2008 by Daus Mahnke, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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