Hydronephrosis is distension and dilation of the renal pelvis and calyces caused by obstruction of free flow of urine from the kidney, leading to progressive atrophy of the kidney.

Hydronephrosis may be unilateral involving just one kidney or bilateral involving both.

A complication of hydronephrosis is decreased kidney function.

The increased pressure of extra fluid within the kidney decreases the blood filtration rate and may cause structural damage to kidney cells.

This decrease in function is reversible if the underlying condition is corrected but if the hydronephrosis lasts many weeks, the damage may be permanent.

Causes:

There are numerous causes of hydronephrosis that are categorized based on whether the cause is intrinsic (located within the urinary collecting system) or extrinsic (outside of the collecting system).

Examples of Intrinsic Causes of Hydronephrosis

Ureter

-Kidney stone: causes obstruction of the ureter as it moves from the kidney into the bladder via ureter so, urine will back up and cause the kidney to swell.
-Stricture or scarring

Bladder

-Bladder stones
-Cystocele
-Bladder neck contracture

Urethra

-The inability to empty the bladder for any reason may cause bilateral hydronephrosis.
– Urethral stricture

Examples of Extrinsic Causes of Hydronephrosis

Ureter

-Tumors or cancers that compress the ureter and prevent urine flow
-Retroperitoneal fibrosis
-Cancer of cervix
-Cancer of prostate
-Pregnancy
-Uterine prolapse
-Scarring due to radiation therapy

Symptoms:

Acute hydronephrosis:

1.Back pain radiating to groin
2.Nausea
3.Vomiting
4.Blood in the urine

Chronic hydronephrosis:

1.Weakness
2.Malaise
3.Nausea
4.Vomiting
5.Electrolyte abnormalities
6.Muscle spasms

Diagnosis:

Taking the history of signs and symptoms.

Reviewing the patient’s past medical history and family history and Physical examination

Laboratory Tests

The following laboratory tests may be useful:

1.Urinalysis to look for infection or abnormal cells.
2.Complete blood count(CBC) may reveal.
3.Electrlyte analysis may be helpful in chronic hydronephrosis since the kidneys are responsible for maintaining and balancing their concentrations in the blood stream.
4.BUN(blood urea nitrogen), Creatinine and glomerular filteration rate(GFR) are blood tests that help to assess the kidney function.

Imaging Studies

1.CT scan of the abdomen can be performed to evaluate the kidney anatomy and make the diagnosis of hydronephrosis
2.Ultrasound is another imaging study that can be done to look for hydronephrosis.
3.Intravenous pyelography (IVP)
4.KUB X-rays (an X-ray that shows the kidney, ureter, and bladder)

Treatment:

The treatment for hydronephrosis is to restart the free flow of urine from the kidney and decrease the swelling and pressure that builds up and decreases kidney function.

The initial care for the patient is to minimize pain and preventing urinary tract infections.

Otherwise surgical intervention may be required.

Shock wave lithotripsy (SWL or extracorporeal shock wave lithotripsy)

Bladder catheterization

Stent placement

Complications :

kidney infections (pyelonephrosis),
sepsis
complete kidney function loss
death

Prevention:

Since hydronephrosis is a situation that occurs because of an underlying cause, prevention depends upon avoiding the underlying cause.

For example, individuals with kidney stones that cause ureteral obstruction and hydronephrosis can be avoided by decreasing the chance of stone recurrence by keeping well hydrated.

Homoeopathic Treatment:

1.Berberis vulgaris:

a.cutting pain or a burning feeling that extends to the urethra
b.The passage may also burn at times when no attempt at urination is being made.
c.After emptying the bladder, the person feels as if some urine still remains inside.
d.Urging and discomfort are often worse from walking.
e.indicated mainly in left-sided renal stones.

2.Sarsaparilla:

a.Frequent urging is felt, with burning pain at the end of urination.
b.Urine passes when the person is standing up, but only dribbling occurs while sitting.
c.Flakes or sediment are sometimes seen in the urine.
d.excruciating pains from right kidney downwards.

3.Lycopodium:

a.This remedy may be helpful if a person has to urinate frequently during the night and passes large amounts of urine.
b.the person may feel a painful urge, but has to strain to make the urine flow.
c.Pain may be felt in the back before the urine passes

Author Bio: Dr Guptha faculty for the medical billing training

Category: Medicines and Remedies
Keywords: medical, coding, billing, training,