Kidney hydrocalicosis does not belong to the category of independent diseases. This pathological manifestation can occur against the background of various pathologies of the organs of the urinary system. The appearance of the disease is due to an increase in the renal calyx, which provokes compression of the parenchymal tissue of the organ. The disease can occur in both one and both kidneys.
Let's take a closer look at renal hydrocalicosis. What is it and how to treat it? What could be the consequences?
Description
In a normal state, the accumulation of urine occurs in the renal calyx, and then it is excreted from the organ through the ureters. If something prevents the outflow of fluid, it accumulates in large quantities and provokes the expansion and extension of the renal calyx. Such changes in the pyelocaliceal system lead to compression of the renal tissues, cause dysfunctional disorders in the functioning of the organ.
Complications
The lack of treatment for this pathology can lead to the following complications:
- urosepsis;
- hydronephrosis;
- chronic renal failure.
The most difficult form of pathology for treatment is bilateral renal hydrocalicosis. What it is? It is diagnosed, according to statistics, in 10-15% of cases, while in the vast majority of patients it is localized on only one side. Experts also argue that more frequent hydrocalicosis of the right kidney. We will consider treatment below.
Causes
Hydrocalicosis is not an independent disease, it is a condition that appears with a number of kidney pathologies. The main reason for this disease is difficulty in removing fluid from the renal calyx. Such a violation can be due to both renal factors caused by diseases of the organs of the urinary system, and extrarenal, provoked by pathologies of other systems in the body.
Provocative factors
Renal factors leading to renal hydrocalicosis are:
- Nephroptosis, or drooping kidney. With this pathology, an inflection of the renal pedicle and ureter occurs.
- Urolithiasis disease.
- Tuberculosis of the kidneys.
- Neoplasms in the kidneys.
- Injury to the urinary system, including the kidneys.
- Diseases of the urinary system of an inflammatory and infectious nature.
- Anomalies in the structure of the urinary organs of an acquired or congenital nature.
- Compression of the calyx due to congenital vascular pathology inside the kidneys.
Extrareal factors
Extrareal factors leading to the appearance of renal hydrocalicosis:
- Neoplasms in the peritoneum, leading to impaired urine output.
- Enlarged lymph nodes behind the peritoneum, as well as defects in the lymphatic vessels, provoking clamping of the urinary organs.
- Injuries to organs adjacent to the kidneys.
Pregnancy
Pregnancy can also cause kidney hydrocalicosis. This pathology is characteristic for the later stages of bearing a child or for a large fetus. This is due to the fact that the uterus begins to put pressure on the urinary organs.
All of the above factors can lead to the development of renal hydrocalicosis. Those patients who already have a similar condition are also at risk. Such people need to monitor the amount of urine excreted. Changes in fluid volume or urinary retention indicate a problem and require specialist advice.
Symptoms
Any signs of renal hydrocalicosis are considered non-specific. To identify the presence of this pathology is often possible only by means of an additional examination. The severity of symptoms directly depends on the rate of development of difficulties associated with the outflow of urine.
The most common complaint of patients with hydrocalicosis is a sharp and pronounced increase in body temperature. Such a symptom is accompanied by chills, and the thermometer can reach 40 degrees. After the outflow of fluid is normalized, the temperature decreases.
In this condition, the following signs of renal hydrocalicosis often appear in patients:
- nausea and vomiting;
- decreased appetite;
- severe weakness.
There is a sharp pain in the lumbar spine. In some cases, it can radiate to the side or groin. Soreness becomes intense with movement and palpation, which significantly worsens the patient's condition. At times of peak pain, vomiting occurs, but this does not bring relief. In addition to fever and soreness, a person experiences frequent urge to urinate, however, liquid is released in small quantities. The urine becomes cloudy and gets an unpleasant odor, sometimes blood clots can be found in it.
Symptoms of renal hydrocalicosis, the appearance of which is provoked by renal causes, are more pronounced and force the patient to worsen. In the case of extrarenal causes, the worsening is slower. Sometimes renal hydrocalicosis can occur latently, that is, without severe symptoms. This is due to the individual characteristics of the body or congenital changes in it. Therefore, it is very important to consult a doctor in time, who will be able to assess the severity of the pathology and prescribe the correct examination and treatment.
Kidney hydrocalicosis also occurs. As for children, their kidneys are large, and the pelvic tissues are not yet fully developed. Therefore, signs of pathology in childhood are different from adults. The disease can occur completely in a latent state or have a pronounced character with fever and acute pain. Often, only an experienced pediatric urologist is able to detect hydrocalicosis.
Diagnostics
The specialist may suspect hydrocalicosis on such complaints of the patient as a sharp increase in temperature of unknown origin, soreness in the lower back and disorders in the urinary process.
To clarify the diagnosis, the doctor prescribes the following studies:
- Ultrasound examination of the kidneys.
- The study of urine and blood, including general and biochemical.
- X-ray examination of the abdominal organs.
- Excretory urography using contrast.
- Urography of the kidneys.
- Computed tomography and MRI of the kidneys, as well as the space behind the peritoneum.
- Multispiral computed tomography.
The number of additional studies is assigned individually. As a rule, blood and urine tests, as well as ultrasound, are enough to determine renal hydrocalicosis. In some cases, a more detailed examination may be required to help draw up a detailed clinical picture and prescribe adequate therapy. So, sometimes more informative types of research are required.
Treatment
Treatment of renal hydrocalicosis is prescribed based on the diagnostic results. Quite often, there is not enough drug treatment, so patients are prescribed surgery that can restore urine outflow.
In some cases, the course of hydrocalicosis takes place in a latent form and does not affect the work of the kidneys, so specialists take a wait-and-see attitude, placing the patient under regular observation. Such patients should be given all the necessary tests twice a year, including an examination of the kidneys using ultrasound.
If hydrocalicosis was triggered by pregnancy, then a woman must follow a special diet, which is due to the ban on the use of most medications during the period of gestation. Most often, after the birth of the baby, the uterus returns to normal and the pressure on the kidneys decreases, restoring the outflow of urine.
Sometimes, against the background of hydrocalicosis, a complication occurs in the form of infection of the kidneys, provoked by stagnation of urine. In such cases, the patient is shown antibiotic therapy. The drug is selected based on a study of urine on the sensitivity of the pathogen to the antibiotic. In addition, the treatment regimen for renal hydrocalicosis is often supplemented with uroantiseptics.
Food
As for nutrition, during the treatment period and especially at the preparatory and rehabilitation stage after surgery, the following recommendations should be observed:
- Eliminate or significantly limit fatty and protein foods.
- Establish a drinking regime by drinking enough clean water throughout the day.
- Increase the amount of vegetables, fruits and dairy products in the diet.
Surgical intervention
To affect the anatomically determined factors causing a violation of the outflow of urine, specialists prescribe an operation that is aimed at eliminating the obstruction of the urinary tract. Such operations are performed both in the classical way (by means of a large incision) and by the minimally invasive method using an endoscope. The method of operation is selected depending on the place where the organ was squeezed, as well as on the severity of the syndrome.
After the operation, the patient must undergo a rehabilitation course. In the future, he is recommended to undergo regular medical examinations by a urologist. Every three months, it is necessary to take tests, as well as undergo an ultrasound of the kidneys.
The further prognosis after surgery directly depends on the factors that influenced the development of the disease. If the cause can be eliminated, then hydrocalicosis should be completely cured. The risk of relapse also depends on whether the root cause of the pathology has been eliminated. So, if hydrocalicosis is provoked by neoplasms, then the prognosis for recovery depends on the successful treatment of the tumor.
Prevention of this pathology
The following can be preventative measures to prevent the development of renal hydrocalicosis:
- Consult a doctor in a timely manner for an early diagnosis. This should be done at the first sign of a disease of the urinary system. This will help to conduct treatment on time and avoid serious complications.
- Take all necessary measures to comply with personal hygiene rules, including sexual.
- Try to avoid hypothermia.
- Eat as recommended by the doctor, adhere to a therapeutic diet.
You must also know which doctor to contact. If we are talking about an increase in the temperature of an unexplained genesis, pain in the lumbar region, frequent urination and a decrease in the amount of urine excreted, then you should first contact a urologist. The specialist will prescribe all the necessary studies, on the basis of which the diagnosis will be made.
Kidney hydrocalicosis is a dangerous disease that can provoke the development of serious complications (up to dysfunctional renal failure). Such a pathology can threaten a person’s life, therefore, all necessary measures should be taken in time if this phenomenon is detected.