Hydronephrosis is a medical condition characterized by swelling of the inside of the kidney due to inadequate elimination of urine from the renal pelvis or backflow or urine from lower portions of the urinary tract.
Hydronephrosis Causes and Risk Factors
Hydronephrosis is a condition that can only develop if there is another underlying illness one is suffering from. For instance, unilateral hydronephrosis is a frequent complication in patients suffering from acute/chronic unilateral obstructive uropathy, people with vesicoureteral reflux and patients with nephrolithiasis. This medial condition may also develop in pregnant women without any apparent cause.
Hydronephrosis generally develops as a consequence of two definitive causes. The first one is blockage somewhere in the urinary tract and the other one is disturbance of the normal working of the bladder associated with the backflow of urine.
Patients, in majority of cases, complain about flank pain, nausea, vomiting and loss of appetite. Depending on the underlying condition there may be plenty of additional symptoms and signs.
Hydronephrosis can be easily diagnosed with ultrasound of the kidneys while additional information regarding the actual cause is obtained with CT scan of the abdomen, MRI of the abdomen, intravenous pyelogram and isotope renography.
Treatment depends on the underlying condition and can be conventional, surgical or combined.
In patients in whom the urether is obstructed, urine flow is re-established with an ureteral stent. A nephrostomy tube allows urine to be drained through the back. All infections require potent antibiotics. More complex treatment is required if patients have only one kidney, additionally suffer from conditions like diabetes, HIV or those who have received a transplant.
As for prognosis, the best prognosis is in patients in whom the kidney has not suffered significant damage. Prolonged, especially untreated, hydronephrosis is always accompanied by complete loss of kidney function i.e. kidney failure.
Potential Complications and Prevention of Hydronephrosis
Fortunately, even if one ends up with severe hydronephrosis and complete loss of kidney function of one affected kidney, he/she still has another kidney which can easily take the role of filtrating blood and eliminating waste via urine. The problem is more complex in individuals with only one kidney functioning. They, unfortunately, completely lose the ability to filtrate blood and must start dialysis.
The only way to prevent hydronephrosis is to timely deal with all the conditions that cause hyderonephrosis in the first place. For instance, even though vesicoureteral reflux is a condition that leads to backflow of urine from the bladder into the kidney, if it is operated on time, patients will not end up with hydronephrosis. There are some conditions which cannot be prevented and are closely related to hydronephrosis. In such case, patients require proper treatment of the primary disease and such treatment may prevent or at least postpone hydronephrosis from developing.