The disease is caused by violation of the outflow of urine from the kidneys, resulting in the pelvis and calices increased hydrostatic pressure.
Allocate congenital hydronephrosis and acquired. Moreover, the disease has three stages. The first stage is characterized by compensated or negligible accumulation of urine in the renal pelvis and its small stretch. At this stage, the kidney function is preserved. In the second stage, the thinning of kidney tissue, while its function is substantially reduced. For the third or end-stage hydronephrosis characterized by a complete shutdown of the affected kidney.
Symptoms of hydronephrosis
It often happens that the onset of the disease goes unnoticed. Hydronephrosis has no specific symptoms, so at an early stage due to the cause of symptoms that it caused. For example, in urolithiasis may cause attacks of renal colic, which are characterized by acute severe pain along the ureter. Sometimes the only symptom of the disease is haematuria (blood in the urine). This symptom is also characteristic of those cases where there was hydronephrosis on the background of urolithiasis.
The most stable sign of hydronephrosis – a constant aching pain blunt nature. Pain can arise in this case irrespective of the position of the body or time of day. Localization of pain right or left depending on which kidney affected. On the background of painful episodes occasionally occur bloating, nausea, vomiting, increased blood pressure. Upon accession of infection increases body temperature.
With the development of end-stage hydronephrosis, especially bilateral, have symptoms of chronic renal failure. This decreases the amount of urine, appear edema, hypertension.
Diagnosis of hydronephrosis
During the visual inspection and palpation with hydronephrosis doctor can detect swelling and deformation of the lumbar region. In order to diagnose this disease conducted laboratory analyzes: urinalysis, complete blood count, tests for Nichiporenko and Zimnitskiy and other.
From instrumental diagnostic methods performed with hydronephrosis renal ultrasound, which allows to define the extension pyelocaliceal complex, increasing the kidney, as well as to measure the thickness of the renal parenchyma.
Appointed radiography – it is the main method of diagnosis of hydronephrosis. Survey radiography reveals stones, determine the size of the kidneys. Intravenous urography contrast, a series of images, determines the rate of formation of urine and its excretion. When hydronephrosis has slowed revenue contrast agents in renal pelvis complex expansion cups and pelvis, which acquire rounded contours. End-stage hydronephrosis contrast can not come to the affected kidney. Occasionally you can discover the nature and level of patency of the urinary tract.
To characterize the extent of damage to each kidney is assigned radioisotope urography. To clarify the diagnosis in difficult cases used angiography, magnetic resonance and computed tomography.
Treatment of hydronephrosis
Correctly chosen and spent treatment helps to compensate for the state and improve kidney function. The main goal of therapy – the elimination of the cause of the hydronephrosis. In each case, except for cause, you must also consider the degree of hydronephrosis and the pace of its development. When hydronephrosis can be carried out medical and surgical treatments.
Conservative treatment for symptomatic hydronephrosis and used at an early stage of the disease. Depending on the symptom such therapy includes anti-inflammatory, anti-hypertensive, and other painkillers. Upon accession infection antibiotics are shown. Typically, conservative therapy precedes operation.
When hydronephrosis in most cases surgery is shown. It is performed to eliminate the causes of illness and recover kidney. Better to do the operation in the early stages of the disease (in particular, congenital anomalies) when still reversible kidney changes. Surgical therapy includes renewal patency of the urinary tract, and terminally ill – plastic pelvis, the restoration of its size. By removal of the affected kidney resort exclusively in advanced cases, when the organ has completely lost its function and its preservation may cause inflammatory complications.
Efficacy of hydronephrosis depends on the stage of the disease. Hydronephrosis – a serious pathology, but timely diagnosis and appropriate treatment given to help maintain and improve the health.