A kidney is an organ that has mobility. Normally, it can move, but no more than a few centimeters. Renal prolapse is scientifically called nephroptosis. Pathology is characterized by an abnormal organ displacement during any movement of a person two or more vertebrae down. The omission of the right kidney is more common than the left. There is nephroptosis at the same time of the whole paired organ, but this phenomenon is extremely rare. In the article, we will talk about the omission of the kidneys, symptoms and consequences, causes and methods of treatment of pathology.
A bit of anatomy
The fixation device is called to keep a kidney in a normal position. It includes the following structures:
- Vessels. They play an insignificant role in fixing the organ, because with nephroptosis they can lengthen.
- Fat capsule. It is a perirenal fatty tissue that performs a fixing, protective function.
- Fascial apparatus. Fascia is located outside the fat capsule, consists of the back and front leaves. They coalesce at the upper pole and form a hanging ligament, which passes into the connective membrane covering the diaphragm. In the fixation of the kidney, the fascial apparatus plays an insignificant role.
- Abdominal ligaments. These are the folds of the peritoneum covering the organ in front. The splenic-renal and pancreatic-renal ligaments fix the left kidney; the duodenal-renal and hepatic-renal ligaments are designed to prevent the prolapse of the right kidney. You will feel the symptoms of nephroptosis if the abdominal ligaments begin to stretch.
- Kidney bed. Formed by the diaphragm, fascia, muscles of the abdominal wall.
Causes of Nephroptosis
The amplitude of movement of the kidney is normally two to five centimeters (often 3.5 centimeters). But there are certain pathological factors that weaken the fixing apparatus, as a result of which the mobility of the organ increases, and the kidney goes down.
In youth, nephroptosis can lead to a sharp weight loss caused by improper nutrition. Also provoking factors can be incorrectly selected physical activity and excessive exercise, leading to sharp drops in intra-abdominal pressure. Infectious diseases that occur chronically and are accompanied by weight loss can lead to the depletion of a fat capsule that protects the organ from movement.
The omission of the kidney can also be associated with improper organization of labor, characterized by the long-term presence of a person in vibration. In addition, nephroptosis often develops as a result of injuries, especially after falls from a height at which the integrity of the ligaments and fascia is impaired. In this case, the fixation of the kidney becomes insolvent. Pancreatic hematomas resulting from trauma to the lumbar region or abdomen can also displace the organ.
Nephroptosis and pregnancy
In women who have already given birth, prolapse of the kidney may be more likely to develop than in those who have not given birth. This is due to a sharp decrease in abdominal pressure after pregnancy due to weakening of the abdominal muscles. As a result, the fixing apparatus is also weakened, and this is a factor predisposing to nephroptosis. The risk of pathology directly depends on the size of the abdomen during pregnancy, the degree of stretching of the anterior wall of the peritoneum, the number of births transferred.
Renal prolapse: symptoms
Patients often do not notice any signs of pathology, and it is usually detected by chance during examination. Indeed, the clinical manifestations of nephroptosis in the event of its occurrence without impairing hemo- and urodynamics are extremely scarce. The severity of symptoms mainly depends on the degree of omission. Based on the clinical manifestations and characteristics of the pathology, three stages of nephroptosis are distinguished.
First stage
One third of the kidney becomes palpable. Its lower edge at the height of inspiration is felt, and on exhalation leaves in the hypochondrium. This stage proceeds without a pronounced clinical picture. If the body drops by seven centimeters or more, dull pain radiating to the lumbar region can occur. Their occurrence is associated with stretching of the fascial capsule.
Also, a person may experience pain during physical exertion, but at rest or when taking a horizontal position, when the organ takes its place in the renal bed, it usually passes. When left kidney prolapse develops, symptoms may also include heaviness in the left hypochondrium.
Second stage
Almost the entire organ comes out from under the costal arch. The kidney in a vertical position of the body by two-thirds becomes accessible for palpation, but as before, when taking a horizontal position, it returns to the renal bed. When the degree of displacement increases, the symptoms also increase. The pains become more intense, reminiscent of renal colic. Unpleasant sensations arise both with a sharp change in body position, and with physical exertion. In addition, changes in the urine are observed: the level of red blood cells and protein increases, which indicates stagnation in the kidney of the blood due to a violation of the venous outflow.
Third stage
The entire organ emerges from under the costal arch; lowering occurs up to the small pelvis. The pains become permanent and often also extend to the inguinal region. Nausea, vomiting may occur. At this time, complications are already developing, including kidney hydronephrosis , pyelonephritis, arterial hypertension. Due to such complications, as well as due to a long disturbance in blood supply during urination, fornical bleeding can occur. There is a risk of a patient developing psychoemotional disorders: neurasthenia, insomnia, depression, dizziness, overexcitation, increased fatigue, and decreased appetite.
Diagnosis of nephroptosis
In the early stages, as already mentioned, kidney prolapse is often detected by chance, although the patient may consult a doctor with complaints of recurrent lower back pain. The main diagnostic method is urography (X-ray examination with contrast). It is carried out in horizontal and vertical positions. In this way, the degree of nephroptosis can be reliably determined. At a later stage of the pathology, when red blood cells are already present in the urine, the most informative diagnostic method is veno- and arteriography (studies of the renal vessels). They are carried out in an upright position. This method makes it possible to accurately determine how much blood circulation is disturbed in the vessels of the organ.
Renal prolapse: treatment
Nephroptosis can be treated conservatively and promptly. When choosing the first option, eliminating the pathology will not work, but unpleasant consequences can be prevented. The patient should use a bandage when lowering the kidneys, perform special exercises, eat intensely (but at the same time correctly).
An operation is prescribed only when there are sharp pains and complications that prevent a person from moving and deprive him of his ability to work, such as vasorenal hypertension, hydronephrotic transformation, pyelonephritis, fornical bleeding, progressive pyeloectasia.
Conservative therapy
The first thing a doctor prescribes is to wear a bandage when lowering the kidneys. If you start using it at an early stage of nephroptosis, you can protect yourself from the progression of pathology and the development of complications. Only in a horizontal position on the exhale should you put on a bandage, do it after waking up, even before getting out of bed.
It is also necessary to perform special exercises when lowering the kidney in order to strengthen the muscles of the anterior wall of the peritoneum. The most effective exercise is the swallow. Lie on your stomach on a hard surface and very slowly lift your legs together, arms and head outstretched to the sides. Fix this position and hold it for a while, and then slowly return to the starting position. Rest a bit and repeat the exercise. You need to do at least fifteen to twenty repetitions, then lie on your stomach for a couple of minutes without moving, then turn on your back and rest for at least half an hour. At first you will feel pain in the kidney area, but it will decrease each time. But remember: the exercises for lowering the kidney that you are going to perform must be coordinated with the doctor.
ethnoscience
As you already understood, neither medication, nor exercise can eliminate kidney prolapse. Treatment with folk remedies also will not return the organ to its place, but it can prevent and eliminate numerous complications.
- With nephroptosis, knotweed infusion should be used. Take it three times a day, one hundred grams half an hour before meals.
- It is worth trying this way: sprinkle a handful of flaxseed with water and sprinkle half a teaspoon of powdered sugar, then fry it all a little in an unlubricated frying pan. Chew the seeds like regular seeds whenever you want. It is also very useful to take sunflower and pumpkin seeds, any nuts.
- Pour two tablespoons of cohia broom (herb) into a thermos, pour one and a half glasses of boiling water and leave overnight. The next morning, strain the resulting infusion and drink it fifty milligrams between meals.
- Finely chop one kilogram of oats straw with scissors and fill with twenty liters of water. Boil for one hour over low heat, then cover and leave for another two hours. Use the resulting broth in the form of heat in the mornings and evenings for taking sitz baths (every other day). Baths should be taken after basic water procedures have been completed. Infusion is allowed to be used several times.
- To increase immunity, take tincture of echinacea, eleutherococcus extract, multivitamins.
Surgery
As a result of the operation, the kidney is fixed, that is, its pathological mobility is eliminated. As already mentioned, nephroptosis is not always an indication for surgical intervention, but only in the presence of serious complications. Before the operation, as a rule, for three days the patient is recommended to sleep on the bed, which has a slightly raised leg end. This helps to return the body to its normal position and facilitates the process.
During surgery, the kidney is fixed in the muscles of the abdominal wall. There are several methods, the choice of a specific method is based on the clinical picture. After the operation, the patient should also lie on the bed, which has a raised leg end. This is necessary for faster and more successful recovery. To adhere to this regimen should be several days, after which the beds give the usual position, and the patient is allowed to get up and walk.
For another two weeks after surgery, anti-inflammatory therapy is performed. At this time, the patient should avoid sudden or prolonged straining during bowel movements. If necessary, microclysters or mild laxative drugs can be used. It should be noted that in almost all patients the operation is successful.
The effects of nephroptosis
Renal prolapse is a pathology requiring compulsory treatment. Otherwise, the likelihood of developing undesirable complications is extremely high. Nephroptosis provokes a violation of the urinary outflow, which, in turn, leads to an increase in pressure inside the kidney. Even at a time when the pathology still does not manifest itself, complications may already arise in the renal parenchyma.
When the normal outflow of urine from the kidney is impaired, a dangerous disease develops - pyelonephritis. It can disrupt the usual life of a person, and sometimes the symptoms are so painful that emergency medical care is required.
Prolapse of the kidney can cause hypertension, and this increases the risk of stroke. Among other things, nephroptosis often entails the formation of kidney stones. A pathology is dangerous for women in the event of pregnancy: spontaneous miscarriage can occur due to omission of the organ.