There are quite a few pathologies that affect the kidneys. The cause of their occurrence is mainly injuries and inflammatory processes. One of these diseases is bilateral renal nephroptosis, which is manifested by pronounced symptoms.
general characteristics
Bilateral nephroptosis is rarely diagnosed and involves the exit of the kidneys from the bed allotted to them and dropping them below the physiological line. In this case, severe pain appears, sometimes twisting around its axis is determined. Such an organ as the kidneys is paired, its functions are to excrete waste products in the form of urine from the body. They also control the metabolic processes in the body. The organs are located in the peritoneal cavity on both sides along the back surface of the spine. If they are located normally, then for each person the left kidney is always lower than the right. This is due to pressure on the last liver. A layer of fat surrounds the kidneys, keeping them in position. If certain factors influence, this layer is able to thin out and the kidneys gradually drop.
Why arises?
The development of bilateral nephroptosis can trigger several factors. A particularly common cause of thinning of the fat layer around the kidneys is a sharp loss in body weight. This can happen during a diet or in a serious illness. As a result, organs become mobile, and pathogenic symptoms appear. The causes of nephroptosis are also:
- pathologies of an infectious nature, which occur in a severe form and affect the retaining elements;
- constant lifting of heavy objects or strong physical exertion;
- abnormalities in the development of ligaments or organs of the genitourinary system;
- defects in the retaining renal apparatus;
- a decrease in muscle tissue tone observed during pregnancy and in elderly patients.
The degree of development of the disease
In medicine, the disease is characterized by three stages of development, each of which differs in its own features.
Bilateral nephroptosis of the 1st degree mainly proceeds without obvious symptoms. It is possible to diagnose a deviation from the norm by palpation with a deep breath of the patient. At this time, the edges of the liver are clearly palpated. The body expires in its position.
Bilateral nephroptosis of the 2nd degree is characterized by a more vivid manifestation of symptoms. You can probe the kidneys completely if the patient is lying down.
The third stage of bilateral nephroptosis is characterized by omission of the kidneys, regardless of the position of the patient. In this case, the most effective therapeutic method is exclusively surgical intervention. Symptoms that accompany the disease appear depending on the stage of its development. The method of treatment is also determined when determining the patient's level of prolapse of the kidneys.
Clinical picture
The initial stage of the appearance of bilateral nephroptosis is rather difficult to determine, since the symptoms are not specific. Initially, there are pulling painful sensations that are localized in the lumbar region and are manifested during physical exertion. However, at rest they disappear. At the first stage, the pain is reflex, the cause of their appearance is irritation of the nerve endings due to renal pressure. Symptoms of bilateral nephroptosis are rather unpleasant.
The second stage is characterized by the appearance of persistent pain that occurs in the lumbar region and gives back. It becomes difficult for patients to be in a standing position. In addition, the composition of urine is changing. Laboratory testing of urine shows that the number of protein compounds and red blood cells increases.
The third stage is characterized by an aggravation of symptoms, the vessels of the organ can twist, which causes circulatory defects and serious consequences for humans. The painful sensations are unbearable, with a change in body position they do not pass. There is also a decrease in appetite and working capacity and sleep disturbances.
Methods of diagnosis and contacting a specialist
If signs of nephroptosis occur, you should consult a nephrologist. Based on the clinical manifestations, the specialist will conduct an examination. The doctor first performs a palpation examination and external examination. In addition, the following procedures are prescribed: analysis of urine and blood; X-ray examination; renal vascular angiography ; Ultrasound scintigraphy. Thanks to the indicators of these studies, the diagnosis of bilateral nephroptosis, the degree of development of the disease, and the therapeutic course are determined.
Treatment methods
Therapeutic methods are directly determined by the severity of the disease. The only effective way in some cases is the intervention of a surgeon. An operation is performed if there are severe pains and a high risk of complications. For the initial stages, drug therapy is suitable. To support the functioning of the kidneys, as well as restore their performance, traditional medicine recipes are used.
If the treatment is conservative, then when diagnosing the disease in the initial stages, various types of drugs are prescribed:
- Painkillers. They are indicated to eliminate pain. The most effective drug is Ibuprofen. Its dosage is determined individually, however, it should not be higher than 800 milligrams per day. 2-3 times a day, 1-2 tablets are taken. Side effects include vomiting, nausea, sleep disturbance, and dizziness. The drug can not be prescribed during pregnancy, as well as with a high sensitivity of the patient to the components in its composition and gastrointestinal diseases.
- The use of antibiotics. If the patient has bilateral nephroptosis, then Ceftriaxone or Augmentin are prescribed. Medicines are characterized by a large number of side effects and are taken exclusively as directed by a specialist in the dosages determined by him.
- Medications that lower blood pressure. It is necessary to take Captopril. Its maximum dose during the day is 150 milligrams. Tablets are drunk 2-3 times a day. The tool must be used very carefully, since many side effects can occur, including pulmonary edema, headache, dizziness, stomatitis, itching, diarrhea, and headache. "Captopril" cannot be prescribed during pregnancy and while breastfeeding, arterial hypertension, defects in the functioning of the liver.
Patients are also recommended to wear a special orthopedic bandage, as well as engage in therapeutic exercises. Thanks to additional therapeutic methods, complications can be avoided, as well as the development of pathology into the third stage.
What else is used in the treatment of bilateral nephroptosis?
Surgical intervention
The most effective procedure is nephropexy. This manipulation consists in the fact that the lowered kidneys are attached, and their location is restored. The preparation time for the operation takes about two weeks. Anti-inflammatory drugs are prescribed for patients to prevent the spread of infection. During surgery, the specialist hem the organ as it is physiologically located. For this purpose, a special implant is used. The operation can only be carried out using the laparoscopic method, thereby reducing the likelihood of complications, and also shortening the rehabilitation period.
Consequences and Complications
If there is no treatment, bilateral nephroptosis can become a source of dangerous consequences, including:
- urolithiasis, in which stones of various sizes are formed in the organs of the urinary system;
- pyelonephritis;
- torsion of blood vessels, due to which blood circulation defects appear;
- hypertensive crisis;
- hydronephrosis when the renal pelvis is full of urine.
A heart attack or stroke may also develop. Untimely treatment or its complete absence causes organ failure.
Recommendations
With such a diagnosis, regular visits to the doctor, periodic delivery of urine for analysis and the passage of an ultrasound procedure are implied. With an unfavorable course of the disease, surgery may be prescribed.
When the kidneys are omitted, it is forbidden to lose weight, moreover, in some cases it is even necessary to gain weight, since the position of the organ is maintained by means of the fat layer. You may need to use an elastic corset. The patient should wear it in the morning after sleep.
Do not lift heavy objects. It is undesirable to engage in such sports where there is a constant shake-up (basketball, volleyball, running, etc.).
Swimming and walking are advised by walking steps. A special physiotherapy exercise has been developed for patients, which strengthens the muscles of the back and abdomen. Muscle tone is very important in maintaining the body in the right position. Professional instructors will help you choose a set of exercises. Gymnastics should be practiced every day, dedication to it thirty minutes in the morning will be excellent. Special massage courses will also benefit several times a year. With a timely visit to a doctor and following all the recommendations, improvements in health will become noticeable.
We examined what it is - bilateral nephroptosis in adults.