by Kimberly Allen ,RN
Hydronephrosis means “water in the kidney”. It is a common congenital disorder with approximately 1 out of every 500 newborns being born with the condition. It affects boys more other than girls and so far has not been linked to any genetic factor, nor have researchers been able to link the condition with anything the parents did before or during pregnancy. Hydronephrosis is also a fairly common condition in adults occurring in approximately 1 out of every 100 adults.
Hydronephrosis is a serious condition that can affect one or both kidneys. Hydronephrosis develops when the urine is unable to drain out of the kidney into the bladder causing a build up of urine in the kidney. There are 2 basic causes of hydronephrosis, either an obstruction or reflux. It is further categorized as either intrinsic or extrinsic. Intrinsic means the blockage is in the urinary collection system while extrinsic means he blockage is outside the urine collection system. Intrinsic causes include kidney stones or blood clots as well as scarring or strictures in the ureter or urethra. Issues with your bladder like a bladder cancer or cystcele are also types of intrinsic causes. Extrinsic causes include a variety of tumors that compress the ureter preventing the urine from leaving the kidney to move to the bladder as well as several conditions that cause scarring. Pregnancy can also be a cause of extrinsic hydronephrosis if the fetus compresses the urinary drainage system of the mother. Reflux is a functional cause of hydronephrosis in which the urine flows backward from the bladder to the kidney. Hydronephrosis that is found in unborn babies during routine ultra sounds is called antenatal hydronephrosis. This type is most commonly caused by improper development of the urinary tract.
The symptoms of hydronephrosis depend on whether or not your blockage occurred rapidly or slowly as well as the location and extent of the blockage. a blockage that develops rapidly is known as acute hydronephrosis. In acute hydronephrosis the most common symptom is severe pain. The pain will be in your back or side, you may also experience in your hip or between your ribs. the pain will be on both sides. In addition to the pain many people also experience nausea and vomiting. Also, if the urine building in your kidney becomes infected you will have symptoms of a kidney infection including a high fever and chills. On the other hand if a kidney stone is causing your hydronephrosis you may also see blood in your urine. If your hydronephrosis develops slowly over time you may not experience any symptoms at all or you may experience the same symptoms as in acute hydronephrosis. Some people with this type experience a dull ache that comes and goes in your side. You may also find that you urinate less often that you used to. Most babies born with hydronephrosis as well as older children tend to have no symptoms and it may resolve on it’s own. However, if your child has been diagnosed with moderate to severe hydronephrosis the symptoms he/she would experience are similar to those adults experience, the most common being pain.
Treatment of hydronephrosis is aimed at restoring the flow of urine out of the kidney, reduce the swelling and inflammation as well as lowering the pressure that has built up while improving kidney function. Initially your doctor will recommend measures including medications to reduce your pain and prevent infection. Then treatment depends on the cause, if it’s a stone you may only need pain control until it passes, or your doctor may recommend shock wave lithrotripsy, however, if it’s caused by a stricture you may need a stent placed in your ureter to allow the urine to pass.
Left untreated the pressure with in the kidney caused by hydronephrosis can lead to multiple complications including loss of kidney function and death. However, when the swelling is resolved the kidneys will usual recover.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.