OverviewNephroptosis - a pathological condition in which the kidney has a greater than normal mobility. In a healthy person, each kidney was fixed in the so-called renal bed, suitable for her renal artery and Vienna, and leaves the ureter. When nephroptosis kidney from the lumbar region can be shifted into the cavity of the abdomen or pelvis. At the expense of disrupting blood vessels (they stretch and contract) and a possible inflection in the ureter nephroptosis worsening renal tissue blood flow, as well as the conditions for the retention of urine in the kidney and the development of inflammatory diseases. Due to the large body of compensatory abilities may Nephroptosis a long time does not manifest itself. However, during this period may cause irreversible changes in the renal tissue. Nephroptosis in women is more common than in men.
Causes of Nephroptosis- Dramatic weight loss over a short period of time (for example, after an infectious disease);
- Trauma of the lumbar area or abdomen can be damaged ligaments that hold the kidney in the renal bed, or the pararenal hematoma formed that displaces the kidney from its normal place);
- After pregnancy and childbirth (this is due to constitutional changes and the weakening of the abdominal wall after birth).
Symptoms NephroptosisIn the development of Nephroptosis distinguish three stages.
At one stage, lowered the kidney can be felt through the abdominal wall on inspiration, on the exhale goes to the upper quadrant kidney (normal kidney can be felt only in very thin people, all the rest, it is not palpable). At this time, may appear aching, dragging pain in the back with one hand while standing. In the patient lying down the pain disappear.
At stage 2 in the vertical position of the patient is out of the whole kidney hypochondrium, but returned to the supine position in the hypochondrium, or it can be safely straighten arm. Pain in the lumbar region, become stronger, may extend to the entire abdomen. Pain aggravated by physical exertion and disappear in the supine position after the kidney back into place.
At stage 3 kidney is completely out of the hypochondrium in any position of the body and can shift in a small basin. Patients note persistent pain in the abdomen, extending to the waist. Pain does not take place in a prone position, aggravated by physical exertion. In the urine after exercise may appear blood.
DiagnosisThe doctor may suspect Nephroptosis have during the inspection and palpation of the patient's abdomen. To confirm the diagnosis carried out blood tests, urine tests, ultrasound of the abdomen and pelvis in the standing and lying down, some special X-ray methods. In the diagnosis of renal ptosis is important not only to establish the presence Nephroptosis, but also to identify possible complications of this disease.
Treatment NephroptosisIn the early stages of the disease in the absence of complications of treatment Nephroptosis performed conservatively (without surgery). Recommend wearing a brace, a set of specific physical therapy to strengthen muscles of the anterior abdominal wall, high-calorie diet to increase the amount of fat (in the case due to the drastic weight loss Nephroptosis).
Surgical treatment Nephroptosis shown in later stages of the disease and the development of complications. During the operation, the surgeon returns the kidney in its bed, and strengthens her there. In the postoperative period is necessary to observe bed rest for 2 weeks to bud firmly entrenched in his position.
ComplicationsComplications due to circulatory disturbance Nephroptosis kidney and urinary flow on the ureters. The most common complications are: