WHAT IS HYDRONEPHROSIS?
Hydronephrosis is a condition where one or both kidneys become stretched and swollen, due to a buildup of urine inside them. It happens when urine cannot drain out from the kidney to the bladder through a blocked urinary tract.
he buildup of fluid in the kidney can be typed in bilateral, left, right, mild or moderate hydronephrosis, etc. The condition in babies is called fetal or congenital hydronephrosis. Its causes are symptoms that are linked to underlying conditions and diagnosing it is often through ultrasound. Hydroureteronephrosis occurs due to the condition.
It most commonly affects one kidney. However, it can occur in both kidneys. It is a secondary condition that develops from some other underlying disease. It is said to affect about one in every hundred (1:100) babies.
TYPES OF HYDRONEPHROSIS
The classification of hydronephrosis depends on the severity of the condition and which kidney it affects.
According To Severity,
- Mild or Moderate Hydronephrosis
This is the buildup of urine in the kidney that is at its early stage and which has not caused any harm to the kidney. This type of hydronephrosis often fades away on its own without treatment.
- Acute or Severe Hydronephrosis
This type of hydronephrosis has begun to cause damages to the kidney. However, the damages are can be easily treated.
- Chronic Hydronephrosis
This type of hydronephrosis happens when hydronephrosis has been left untreated for a long time, resulting in chronic kidney disease (CKD), which can lead to kidney failure.
According To Affected Kidney,
- Left Hydronephrosis; the buildup of urine in the left kidney.
- Right Hydronephrosis; the buildup of urine in the right kidney.
- Bilateral Hydronephrosis; the buildup of urine in both kidneys.
Another type of hydronephrosis is:
- Congenital Hydronephrosis
This is hydronephrosis that occurs in babies before their birth, that is, it occurs in the fetus during pregnancy. It is also called “fetal hydronephrosis” or “antenatal hydronephrosis”.
Hydronephrosis is usually diagnosed using an ultrasound scan, which uses sound waves to create a picture of the inside of your kidney. A swollen kidney will show clearly.
Further tests are necessary to determine the cause of the condition, which may include:
- Blood test; to determine the presence of infection.
- Urine test; to check infection and traces of blood (which can be caused by a kidney stone)
- Intravenous urography; which is an x-ray of your kidney. A special dye is injected into your bloodstream to highlight the flow of urine through your urinary tract. This is used to identify any blockages.
- CT Scan; which uses multiple images and a computer to build up a 3-D image of the inside of your body.
Diagnosis In Babies
Hydronephrosis may be diagnosed in a fetus while a mother is pregnant, using a routine pregnancy ultrasound scan at around 20 weeks. This is called antenatal, fetal, or congenital hydronephrosis.
If your baby is diagnosed with hydronephrosis, you should have other follow-up scans during your pregnancy to check your baby is growing normally or the kidneys are not getting too large. The problem, in most cases, always improves before the baby is born or within a few months after delivery.
Scan your baby regularly after delivery to monitor his/her condition, to ensure there is no continuing problem, and see if treatment is necessary. These scans may include:
- An ultrasound scan
- Micturating cystourethrogram (MCUG)
- Dimerceptosuccinic acid (DMSA)
- MAG-3 scan.
Treatment for hydronephrosis is dependent on what is causing the condition and the severity of the condition.
In adults, the treatment is aimed at:
- Removing the buildup of urine and relieving the pressure in the kidney.
- Treating the underlying causes.
- Preventing permanent kidney damage.
Treatment methods include:
Most people will need a catheterization procedure to drain the urine from the kidneys. This will help ease the pain and prevent any further damages to the kidneys.
A thin tube (catheter) is inserted into your bladder through your urethra (the tube that carries urine out of the body) or directly into your kidney through a small cut in your skin.
If the kidney is damaged, it may be removed. It is possible to live life normally with one healthy, functioning kidney.
A nephrectomy is performed to deal with a diseased or seriously damaged kidney. A urologic surgeon may perform the procedure through a single incision in the abdomen (open nephrectomy) or through a series of small incisions in the abdomen, using a camera and small instruments (laparoscopic nephrectomy).
- Treating The Underlying Causes
Once the pressure on your kidney has been lifted, the cause of the build-up of urine needs to be treated.
Treatment of some possible causes may include:
- Removal of kidney stones through surgery, or breaking them through sound waves.
- Medications to reduce enlarged prostate can be taken, or surgery can be used to remove some of the prostates.
- Chemotherapy, radiotherapy, or surgery to fight cancer.
- For a narrowed ureter, inserting a hollow plastic tube (stent), which will allow urine to flow through the narrowed section.
- Use of medications such as antibiotics, pain relief drugs to treat urinary tract infections, and other related diseases.
- Surgery to remove scar tissues and blood clots.
- Surgery to correct pelvic organ prolapse.
Treating Hydronephrosis In Babies
Most babies diagnosed with hydronephrosis before birth (fetal hydronephrosis) will not need any treatment because the condition may fade away after some time before they are born or within a few months after delivery.
There is usually no risk to both baby and the matter, so labor may be safe. After birth, your baby is examined to check for any possible problems, such as swollen kidneys before taking him/her home.
Post-natal check-ups are necessary after delivery. Your baby needs a routine follow-up visit to the hospital, and scans are performed during the next few weeks to ensure there are no continuing problems.
Congenital hydronephrosis will improve as your child gets older. However, until the scan shows that there is no more problem, your child may need to take some antibiotics to reduce the chances of developing urinary tract infections as the urine inside his/her kidney can make it more likely for him/her to have an infection.
Your child should continue on the antibiotics until the hydronephrosis gets better. If resistance prolongs, surgery may be the next line of action to treat the condition.
If hydronephrosis is left untreated, the affected kidney may be permanently damaged. Kidney failure is rare if the other kidney is working optimally. However, kidney failure is likely to occur if both kidneys are affected.
Urinary tract infections and severe abdominal pains may also occur.
The signs and symptoms of hydronephrosis are often linked to the underlying causes of the condition. They may include:
- Abdominal pains
- Swollen abdomen
- Urinary tract infection (UTI)
- A frequent urge to urinate.
- Painful urination.
- Burning sensation during urination.
- Urinating in little bits.
- Incomplete bladder emptying.
- Bladder pains.
The buildup of urine in one or both kidneys can be caused by the following:
- Kidney stones
- Scarring of tissues, as a result of injury or previous surgery.
- Blood clots
- Tumor or cancer.
- The congenital blockage is a defect that comes from birth.
- Urinary tract infection (UTI)
- A disease that induces inflammation of the urinary tract.
- Enlarge prostrate (noncancerous), in men.
- Pregnancy, which causes compression due to a growing fetus.
- A narrowing of the ureter due to injury or birth defect.
- Damaged nerves around the bladder.
- Pelvic organ prolapse in which one or more pelvic organs bulge into the vagina.
- How long does it take for hydronephrosis to heal?
Hydronephrosis can go on its own between 1 to 3 weeks if mild. The healing duration via treatment is between 2 to 3 weeks.
- Does hydronephrosis go away?
Yes, hydronephrosis can be resolved on its own if it is mild.
- Is hydronephrosis a birth defect?
Birth defects in the urinary tract may cause hydronephrosis. Even when birth defects are the cause, hydronephrosis may be mild and may improve as the child gets older. However, birth defects may also cause hydronephrosis that is severe or gets worse over time.
- Can hydronephrosis be cured?
Hydronephrosis occurs as a result of underlying diseases or conditions such as kidney stones, UTI, birth defects, tumors, cancers, etc.
Some cases can be resolved without surgery; infections can be treated with antibiotics, kidney stones can pass through on their own or can be broken down, etc. When the underlying causes are taken care of, hydronephrosis can be cured.
- What foods should I avoid if I have hydronephrosis?
Avoid processed foods and meats like ham, bacon, sausages, etc. Eat more fruits and vegetables rather than junk foods. Avoid canned and frozen foods, and foods high in sodium.
- What is hydroureteronephrosis?
This is a condition that occurs due to the obstruction (blockage) of urine flow from the urine, causing a dilatation of the ureter, calyxes, and renal pelvis.