This book describes Swollen Kidney, Diagnosis and Treatment and Related Diseases
Swollen Kidney (Hydronephrosis) is a disorder in which one or both kidneys become stretched and swollen due to the accumulation of excess urine.
Hydronephrosis happens when there is either an obstruction of the outflow of urine, or reverse flow of urine already in the bladder (called reflux) that can cause the renal pelvis to become enlarged.
It can involve people of any age and is from time to time observed in unborn babies during routine pregnancy ultrasound scans (known as antenatal hydronephrosis).
Hydronephrosis does not normally cause any long-term disorders if it is diagnosed and treated promptly.
The disorder can raise the chances of getting urinary tract infections (UTIs).
In severe cases that are not treated, the kidney may become scarred, which could result in a loss of kidney function
The disorders with any of these urinary parts may induce fluid to reflux back into the kidney.
If only one of the kidneys is affected, the disorder is called unilateral hydronephrosis.
If both kidneys are affected, it is called bilateral hydronephrosis.
Hydronephrosis may lead to decreased kidney function.
If not managed quickly, permanent damage to the kidney or kidneys may happen, leading to kidney failure.
Risk Factors
1.Pregnant women (due to an enlarging womb that may compress the ureters);
2.Men over the age of 50 (due to enlargement of the prostate or prostate cancer);
3.Sexually active women (due to their risk for recurrent urinary tract infections);
4.Those who are predisposed to recurrent kidney stones.
Causes
Hydronephrosis happens as the result of an illness.
Hydronephrosis is not considered a disease.
One of the most frequent causes of hydronephrosis is acute unilateral obstructive uropathy.
This is a sudden development of a blockage in one of the ureters, which are the tubes that connect the kidneys to the bladder.
The most frequent cause for this obstruction is a kidney stone but blood clots and scarring can also induce acute unilateral obstructive uropathy.
A blocked ureter can induce urine to go back up into the kidney, which produces swelling.
This backflow of urine is identified as vesicoureteric reflux (VUR).
Other reasons of blockage may be:
1.A kink in the ureteropelvic junction, which is where the ureter meets the pelvis of the kidney
2.An enlarged prostate gland in men, which can be because of BPH or prostatitis
3.Pregnancy, which produces a compression due to a growing fetus
4.Tumors in or near the ureter
5.A narrowing of the ureter from an injury or birth defect
Symptoms
Hydronephrosis may or may not produce symptoms.
The main symptom is pain, either in the side and back (known as flank pain), abdomen or groin.
1.Pain in the lower abdomen
2.Nausea
3.Vomiting
4.Pain when urinating (dysuria)
5.Blood in the urine
Diagnosis
Most patients manifest with non-specific symptoms, such as dull abdominal pain, of less than 12 months' duration
The doctor may occasionally be able to feel the enlarged kidney by gently massaging the abdomen and flank area
An ultrasound is normally used to confirm a diagnosis
A doctor can also confirm a diagnosis with x-rays, computerized tomography (CT) and magnetic resonance imaging (MRI).
Treatment
If the patient has hydronephrosis, the treatment will be dependent on the underlying cause and its severity.
Pregnant women and babies may not require any treatment.
Treatment for hydronephrosis primarily directs on getting rid of the blockage of the flow of urine
1.Insert a ureteral stent or a nephrostomy tube to drain the fluid
2.Remove the obstruction with surgery e.g. kidney stone, scar tissue or blood clot
3.Antib