Hydronephrosis

Introduction Hydronephrosis refers to the accumulation of urine in the kidney. When the urine of the renal pelvis and kidney is more than normal, it is called hydronephrosis. When the hydronephrosis capacity exceeds 1000ml, or when the child exceeds its 24-hour urine volume, it is called giant hydronephrosis. Hydronephrosis is caused by obstructive diseases of the upper urinary tract. Common causes are congenital ureteropelvic junction stenosis, ureteral stones, etc. Long-term lower urinary tract obstruction can also lead to hydronephrosis, such as benign prostatic hyperplasia, neurogenic Sexual bladder dysfunction and so on. The degree of water accumulation is light, medium and heavy. When mild, only the renal pelvis expands, and the renal pelvis expands when it is moderate. When the kidney is thick and spleen, the kidney becomes a sac.

Cause

Congenital pelvis and ureteral junction stenosis, ureteral stones. As the urine in the kidney accumulates, the pressure rises, causing the renal pelvis and renal pelvis to enlarge and the renal parenchyma to shrink. If the urine is infected, it is called infectious hydronephrosis; when the kidney tissue is necrotic due to infection, the kidney is full of pus, called kidney empyema or pus. The main cause of hydronephrosis is obstruction at the junction of the pelvis and ureter.

an examination

Related inspection

Urine routine renal pelvis pressure measurement

1. Signs: It can be further examined from the signs of pain, swelling, and abdominal mass in the kidney area to determine whether there is upper urinary tract obstruction.

2. Laboratory examination: 1 routine urine examination: early patients with mild hydronephrosis urine can be normal, when the development of the renal pelvis enlargement can appear hematuria and proteinuria. A large amount of proteinuria and casts are not common in upper urinary tract obstructive diseases. 2 Renal function test: Renal function test in patients with unilateral upper urinary tract obstruction hydronephrosis is generally not due to contralateral compensation. The phenol red test and sputum excretion test indicate that there is damage indicating bilateral kidney damage. When severe bilateral hydronephrosis occurs, the urine flow is slow through the renal tubules, and a large amount of urea is reabsorbed, but creatinine is generally not absorbed, which results in a ratio of urea to creatinine exceeding the normal 10:1. When renal parenchymal damage seriously affects renal function, both serum creatinine and endogenous creatinine clearance will increase. 3 anemia: appears in the renal dysfunction of both kidneys.

3. Ultrasound examination: can understand the degree of renal and ureteral hydrops, the degree of renal parenchymal atrophy, can also initially detect the location and cause of obstruction, and can guide the puncture angiography.

Differential diagnosis

Identification of stones or congenital ureteral stricture.

Renalcalculus is mostly located in the renal pelvis and renal parenchyma is rare. The plain film shows that the kidney region has single or multiple circular, oval or blunt triangular dense shadows with high density and uniformity. The edges are smooth, but they are also matte and mulberry-like. Small stones in the renal pelvis and renal pelvis can move with the body position. The shape of the larger stone is consistent with the shape of the cavity, which can be expressed as a typical staghorn or coral. Sometimes stones can fill the entire renal pelvis and renal pelvis and resemble the performance of pyelography. Lateral view, most of the kidney stones overlap with the spine.

There are many causes of obstruction of urinary flow, which can be congenital, such as kidney, ureteral junction stenosis, urethral valve, horseshoe kidney, etc., acquired diseases such as stones, tumors, benign prostatic hyperplasia, bladder neck contracture. It can also be caused by fibrous band or tumor compression outside the urinary tract, such as retroperitoneal fibrosis, lymphoma and the like. It can also be a urinary tract neuromuscular disorder such as giant ureteral disease. Obstruction is divided into acute and chronic, acute obstruction makes the kidney completely lost in a short time, while hydronephrosis is not very obvious. Chronic obstruction can cause more than 1000 ml of water in the kidneys. Once the hydronephrosis is complicated, if the obstruction is not relieved in time, the infection is difficult to cure, and the infection accelerates the destruction of the kidney, forming a vicious circle and even forming a pus.

You can diagnose by doing an imaging examination.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.