What kind of water flushes out kidney stones? The appearance of fluid in the kidneys: causes and treatment methods. Treatment of congestion in the kidneys

03.03.2019

Appears due to the occurrence of salt deposits in the renal pelvis in the form of sand or a dense formation. In modern the world is easy the degree of the disease can be found in 30% of the world's population. The grains of sand that form rarely exceed 1 mm in diameter, so they do not cause persistent pain and are independently washed out of the body along with urine. Large deposits over a long period of time form stones large size, which can reach 2 cm in diameter or more. It is difficult to remove such stones on your own; medical or surgical intervention is required. From the stones small size it is possible to get rid of it by significantly increasing the volume of fluid consumed or using a diet. An alternative method of treatment, according to experts, is mineral water.

Which mineral water is good for the kidneys?

Not every mineral water is healthy for drinking when urolithiasis occurs. Therefore, depending on the elements contained, one mineral water can help, while another can seriously harm your health. If the water is selected incorrectly, the disease may develop negatively.

Competent selection of mineral water for cleansing kidney stones is carried out using the method of counterbalancing excess substances contained in excess in the patient’s body.

The best option to drink clean water, which does not require carbonation and does not contain minerals. If there is too much chlorine in the liquid, then it is better to refuse such a drink. The choice of water that is beneficial for the body should be made by a professional doctor. Before prescribing, analysis must be carried out to determine the composition of the substance from which the stones were formed.

Mineral water has a number useful properties, helping in the treatment of urolithiasis. Right choice water helps to obtain quick results. But the main role is played by drug treatment, which should not be neglected.

Advantages of mineral water therapy:

  • absence of harmful substances;
  • presence of useful substances:
  • diuretic effect;
  • increasing fluid intake;
  • grinding

Stones formed in the renal pelvis are of 3 types: urates, phosphates and oxalates. Determining the type of stones – necessary procedure for the correct course of treatment. Depending on the qualitative composition of the formations, the choice of mineral water is made.

Choice of water for stone formation:

  • for phosphaturia, slightly acidic water that does not contain phosphorus is used. To crush phosphate type stones, the water must include tungsten, iron and silicon;
  • the same substances are used to destroy oxalates, but the presence of calcium is excluded and slightly alkaline mineral water is used;
  • If urates occur, take a slightly alkaline mineral water.

List of names used for treatment:

  • Essentuki No. 4. Contains sodium, chloride and bicarbonate, including a small proportion of carbon dioxide;
  • Berezovskaya. Consists of iron, bicarbonate, magnesium and chloride;
  • Essentuki No. 20. Consists of sulfate, magnesium, as well as calcium and bicarbonate;
  • Naftusya. Contains useful minerals and essential magnesium and potassium.

A brief description of the properties will help you choose best option what kind of water to drink for kidney stones. “Essentuki” No. 4 is the highest quality water, promotes the functioning of the kidneys and gastrointestinal tract, and normalizes liver function. "Essentuki" No. 17 has more high level mineralization, used only as prescribed by a doctor. “Essentuki” No. 20 is a low-mineralized drink that improves metabolism and restores kidney function. "Berezovskaya" is often used to treat neuroses, gastrointestinal tract, musculoskeletal system and urinary tract. “Naftusya” is indispensable in the treatment of kidneys.

There are several types of mineral waters with high content minerals. "Atsylyk" - helps with diseases of the gastrointestinal tract, liver and urinary tract. "Narzan" - sparkling water. It is used to treat kidney dysfunction, promotes the dissolution of phosphates, and is a natural diuretic. "Borjomi" is a diuretic drink that helps in detoxifying the body. Used diluted. The composition of the solution depends on the concentration of the mineral water; data from the urine test and the presence of concomitant diseases or complications should be taken into account.

Indications for treatment with mineral water

Experts have proven that you can drink mineral water to replace intercellular fluid with negative water with a high-quality structure, which allows you to improve the functioning of the body’s cells. Mineral water is often used both for drinking and for rinsing the mouth, enemas or gastric lavage.

Mineral water as a means of treatment helps to cope with an extensive list of diseases:

  • intestinal dyskinesia, gastritis, gastrointestinal diseases, stomach ulcers;
  • pancreatitis, obesity, Botkin's disease;
  • urolithiasis, cystitis, diathesis.

Mineral water for urolithiasis is used exclusively for internal use.

Contraindications for treatment with mineral water

Quite often, the doctor prescribes treatment with mineralized water for diseases such as:

  • pyelonephritis;
  • urolithiasis disease;
  • cystitis;
  • urinary diathesis.

To determine the mineral water that will be required for treatment specific disease, you need to undergo an examination and the doctor will prescribe a course of treatment. This process helps to avoid negative effects. There are many contraindications for taking mineral water:

  • organ tuberculosis;
  • hydronephrosis;
  • renal failure;
  • inflammatory processes of the urinary tract;
  • the prospect of surgical intervention to remove stones.

There are also a number of contraindications for inflammatory processes gastrointestinal tract accompanied by vomiting and possible bleeding. If there are any obstacles to the passage of food, completely stop drinking mineral water. People who have excess weight, you should not drink carbonated water because it increases the feeling of hunger, and if you have hypertension, it is better to drink low-mineralized water.

Rules for taking mineral water

Achieving a positive effect when drinking a mineral drink is due to compliance with a certain sequence:

  • Washing out harmful substances and destroying mucus.
  • Formation of protective colloids to improve the solubility of salt deposits in urine.
  • Reducing the amount of urine to prevent the formation of salts.

It lasts on average from 1 to 1.5 months. At this time, all the described stages occur. As the duration of the procedure increases, changes in water-salt metabolism are possible.

The most favorable water is extracted directly from natural sources, near which there are sanatoriums. To achieve a high-quality result, it is worth undergoing a course of treatment there. Due to the complexity of the disease, the frequency of the procedure can be up to 3 times a year. It is recommended to buy water at the pharmacy exclusively in glass containers.

Recovery forecasts

To prevent urolithiasis, you need to drink a mineral drink daily in a specific volume - at least 1.5 liters per day. This volume helps reduce the formation of salts and remove sand and small-diameter salt build-ups from the kidneys. Regular use prevents the formation of new stones in the renal pelvis. Water with low mineralization does not contain salts, which can contribute to the appearance of new stones. Almost every type of mineral water is a diuretic, which helps cleanse the urinary tract, increases protection against infectious diseases and reduces the amount of uric acid, reducing the risk of stone formation.

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Fluid in the kidneys causes and treatment

Fluid in the kidneys: causes and treatment of hydronephrosis

Hydronephrosis or the accumulation of water in the kidneys is a pathology in which the renal collecting system expands, leading to parenchymal atrophy. Being a serious disease, hydronephrosis without timely treatment will lead to the need surgical intervention. Violation of the outflow of urine does not appear immediately, so it is extremely important to recognize the symptoms of the disease in time and begin prevention and therapy as early as possible.

Hydronephrosis: definition, classification of pathology


Hydronephrosis or accumulation of water in the kidneys is a pathology in which the renal pyelocaliceal system expands, leading to parenchymal atrophy

Hydro - water, nephro - kidney, translated from Latin the translation of the name of the disease speaks for itself: the concentration of fluid at a local point. Moving into the acute stage, the pathology leads to destruction renal functions, violation metabolic processes and infection of the patient’s entire body.

The disease can be diagnosed immediately after birth - a congenital variant or during life - acquired. The pathology can affect one or both kidneys, while bilateral inflammation disrupts the outflow of urine in the lower reaches of the urinary tract: the ureter, urethra.

The disease is classified into three degrees:

  1. The first degree is manifested by a slight expansion of the pelvis due to increased pressure on its walls. At the same time, the organ still retains 100% of its functions.
  2. The second degree is a moderate or significant expansion of the pelvis and cups. The accumulated fluid in the kidneys puts pressure on the parenchyma, blocks the tubules, the functionality of the organs is preserved by 40-45%;
  3. The third degree is characterized by atrophy of organ tissue, and the process is already irreversible, leading to complete death of the kidney and a threat to the patient’s life.

Causes of the disease


The causes of the disease are insufficient functionality of the ureteral valves, leading to reverse flow of urine

Doctors find it difficult to determine the causes of the disease with 100% probability, but there are many factors that provoke the accumulation of fluid in paired organ:

  1. Obstructions and/or genetic disorders of the direct flow of urine formed in the ureter, bladder;
  2. Insufficient functionality of the ureteral valves, leading to reverse flow of urine.

Important! Hydronephrosis congenital type has underlying diseases: dysthenesia, abnormal development of urinary organs excretory system, obstruction. The acquired disease basically contains urolithiasis, neoplasms of benign/malignant type, others urological pathologies

Symptoms of hydronephrosis


A clear clinical picture appears towards the end of the second, in the third stage, when blood appears in the urine

At the first stage, it is difficult to notice the disease. Aching pain in the lower back, fatigue is written off as a common malaise. However, it is these nonspecific symptoms, as well as a decrease in daily urine volume, that should alert the patient. A clear clinical picture appears towards the end of the second, in the third stage, when blood appears in the urine. Hematuria is noticeable to the naked eye, and in combination with constant local pain, the symptoms directly indicate problems with the kidneys - you cannot put off a visit to the doctor!

Important! In young children, hydronephrosis can be diagnosed during the period of intrauterine fetal development. In this case, parents are warned in advance about what measures will have to be taken to prevent and treat the disease.

Detection of pathology on early stage– a big coincidence, but if the patient notices signs of renal colic:

  • Pain when urinating;
  • Fluctuations in temperature, blood pressure;
  • Constantly stupid aching pain in the lower back with “recoil” to the groin;
  • Nausea, headache, vomit;
  • General weakness, anemia;
  • Blood in the urine;
  • Frequent urge to urinate with a decrease in the total daily volume of urine;
  • Swelling of the arms, legs, face.

You need to see a doctor as quickly as possible - these signs directly indicate the progression of hydronephrosis.

Important! Due to neglect, the pathology often leads to rupture of the renal pelvis. It will take a lot expensive treatment and removal of the organ to prevent the infection from spreading throughout the body

Complications


The worst outcome of the disease is kidney failure.

The worst outcome of the disease is kidney failure. The organs completely refuse to function, and the patient remains tied to hospital bed. Blood filtration is not performed, which means contamination with metabolic products occurs, which leads to infection and death.

Urolithiasis is another complication. If infection is associated with the formation of stones, the pathology is aggravated additional diseases and long-term, expensive treatment will be required to restore kidney function and relieve infectious diseases.

Diagnosis and treatment


To diagnose the disease, the specialist, in addition to collecting an anamnesis, invites the patient to undergo a full comprehensive examination

Hydronephrosis of the kidneys - concomitant pathology, therefore, without treating the underlying disease, all efforts will be ineffective. To diagnose the disease, the specialist, in addition to collecting anamnesis, invites the patient to undergo a full comprehensive examination:

  • urine and blood tests general type;
  • Ultrasound of the kidneys, which helps determine the size and dynamics of the disease;
  • x-ray of organs to view enlarged pelvis;
  • radioisotope scanning to determine the degree of impairment of functionality.

CT, MRI, angiography may also be offered. All procedures are important for making the correct diagnosis and selecting treatment. Conservative techniques often they don't give desired result and are usually used as preparatory stage before surgery: to reduce pressure in the kidneys and reduce the intensity of the inflammatory process.

Surgery is the main path to healing. Today, surgeons prefer reconstructive techniques that preserve the organ. The choice of options is large and it all depends on the age of the patient, clinical picture and dynamics of pathology.

Important! Nephrectomy is performed only if complete defeat parenchyma, loss of functionality and a high threat to the patient’s life. Most often, complete removal of an organ occurs in older people.

At an early stage of the disease, it is enough therapeutic methods, maintaining a diet, regular examination and prevention of pathology. If the doctor's recommendations are followed, the disease is reversible and in 86% of cases patients do not experience negative manifestations diseases.

Diet therapy and drinking regimen

Despite the simplicity of the advice, diet therapy, coupled with compliance drinking regime and a healthy lifestyle can significantly reduce the symptoms of the disease, and then serve as an excellent prevention of pathology. When choosing a menu, it is better to avoid fatty, heavy dishes, giving preference to raw vegetables and fruits.

The volume of fluid consumed for a patient without additional diseases, is at least 2-2.5 liters per day. The doctor will explain the details of the diet: the diet is selected individually, however, reducing the amount of spicy, sweet, and smoked foods will only come in handy, as will giving up alcohol, strong coffee, and tea. Dishes introduced into the diet should be rich in amino acids, which are not synthesized by the body, but are obtained only from foods.

Important! Limitation or complete exclusion table salt– a mandatory part of the diet for hydronephrosis. The most suitable is a potato-egg diet with a reduced calorie content and high performance amino acid levels. In addition, the products do not increase the load on the gastrointestinal tract and remove excess cholesterol and are processed by the body of a patient of any age. You cannot keep this diet for a long time! The timing of nutrition will be advised only by a highly specialized doctor, whose consultation is required.

Lecheniepochki.ru

Where does fluid in the kidneys come from?

Fluid concentrated in the kidneys indicates serious disturbances in the functioning of the urinary system.


Human kidneys

Excess water in the body, as well as deficiency, negatively affects the general condition of a person.

  • Functions
  • Causes
  • Diagnostics
  • Treatment

Kidneys are internal human organs responsible for purifying the blood, removing toxic substances, and maintaining water-salt balance.

Healthy kidneys prevent accumulation in the body excess water. Water itself is important for the normal functioning of all human internal organs.

Its quantity cannot be less than two liters per day. Thanks to the flow of water, all harmful substances are washed away.

Genitourinary system

The kidneys regulate the amount of fluid by excreting excess fluid in the form of urine, which is a solution consisting of water and waste products.

The amount of water and waste that the kidneys filter daily can vary greatly. The urinary system itself regulates processes, calculating the needs of the body.

For colds or infectious diseases, when there is an increase in temperature, the patient begins increased sweating, resulting in significant fluid loss.

In these cases, the kidneys reabsorb water from the tubular fluid a little more than on other days. Accordingly, much less urine is released, it becomes more concentrated and darker.

But the kidneys, through such actions, prevent dehydration of the body.

However, according to various reasons sometimes the body malfunctions, resulting in fluid excretion without visible reasons slows down.

Its excess must concentrate somewhere, so the fluid begins to fill the renal pelvis and calyces, which begin to increase in size, creating a certain load on the kidneys.

The renal pelvis changes in external shape, becoming more and more like swollen sacs. All these signs indicate that the patient has the renal disease hydronephrosis.

The name itself indicates that it accumulates in the kidneys excess liquid. Translated from German, hydronephrosis is characterized as “a kidney in the form of a bag of water.”

Causes

The reasons why the kidney is unable to remove excess fluid can be completely different:

  • hereditary;
  • congenital;
  • acquired.

Kidney pathologies

Congenital hydronephrosis is caused by improper formation of the renal organ in the prenatal period. This may be due to reflux, where the valve (sphincter) between the kidney and ureter is unable to close completely.

As a result, urine flows back into the kidney. A healthy kidney releases urine into the ureter, closes the valve, and then the urine enters the bladder and is excreted.

At malfunction valve, urine entering the ureter, under the influence of pressure changes, again rushes into the kidney.

Kidney diseases

It is for this reason that urine begins to accumulate in the kidneys instead of the bladder.

Due to the fact that urine is a waste material saturated with toxins, it cannot bring anything good to the kidneys except harm.

Inner walls the organs begin to deform, the renal pelvis expands, and the weight of the kidney increases due to the large amount of fluid. In advanced forms, the patient additionally acquires pyelonephritis.

Hereditary disorders manifest themselves in the form of neuromuscular diseases, when, for example, the functions of emptying the bladder are impaired. Such disorders are passed on from generation to generation.

If one of your immediate relatives had problems with excess fluid in the kidney organs, then the future baby may inherit such abnormalities.

An acquired disease may be a consequence of another disease associated with the urinary system. These could be tumors urolithiasis, stenosis and others.

Unfortunately, this can be caused by side effects of some medications. In some cases, doctors cannot determine the reasons why fluid began to stagnate in the kidneys.

Depending on the degree of damage to the inner walls of the kidneys, renal pelvis and calyces, four stages of the disease are distinguished.

The most dangerous is the fourth, since the kidney tissue is completely damaged and the kidney stops working.

The first stage is characterized only by the presence excess liquid, but no tissue damage has yet been observed.

Diagnostics

To prevent the transition of hydronephrosis to the fourth stage, it is important to monitor the symptoms; at the slightest complaint, contact a medical institution, where they will conduct a full diagnosis, determine both the disease itself and its stage.


Effective diagnostics

Full information about the problem will create the basis for prescribing the correct treatment.

One of the symptoms indicating that a patient is beginning to develop hydronephrosis is renal colic.

As the disorder develops, pain is noted in the area where the kidneys are located, and a decrease in their activity is also recorded. N

and at this stage the first swelling appears, the arterial pressure, due to the fact that it is seriously violated water exchange. Sometimes, with hydronephrosis, blood may appear in the urine.

Hydronephrosis

To establish accurate diagnosis laboratory and instrumental diagnostic methods are used. TO laboratory species include blood and urine tests.

An increase in the level of urea and creatinine detected during a biochemical blood test indicates renal failure, including bilateral hydronephrosis.

Carrying out this analysis makes it possible to detect hyperkalemia in a timely manner, which is very dangerous not only for human health, but also threatens his life.

Instrumental diagnostic methods that help identify problems associated with kidney function include:

  • cystoscopy;
  • urography;
  • CT scan;
  • radioisotope renography.

Carrying out diagnostics

When performing an ultrasound, the doctor can determine the size and shape of the kidneys, developmental abnormalities, and the presence of cysts or stones.

Cystoscopy can detect problems associated with obstructions to the normal outflow of urinary fluid.

Using urography, X-rays are taken, which, when examined, determine the presence of problems and the degree of their development. WITH

Modern instrumental diagnostics make it possible to promptly detect the problem of fluid concentration in the kidneys, as well as other anomalies.

Having identified the disorders and understanding the cause of their occurrence, it is easier for the doctor to prescribe effective treatment.

Treatment

At initial stage hydronephrosis, when the fluid is just beginning to stagnate, but the kidney tissue is not yet destroyed, conservative treatment is recommended.


Conservative treatment

The measures are aimed at relieving pain and restoring the outflow of urinary fluid, thereby preventing the manifestations of the inflammatory process.

Unfortunately, when hydronephrosis is in the third or fourth stage, conservative treatment will no longer bring tangible benefit, so the patient is recommended surgical treatment.

Surgery

The purpose of the operation is also to regulate the outflow of fluid. It is possible to achieve the set goals through the use of various techniques, one of the options is to install a nephrostomy.

A nephrostomy is a special tube that resumes the outflow of urinary fluid, as a result of which the kidney organ shrinks and returns to its standard size. inflammatory process also stops.

The urgency of surgical intervention is determined by the doctor based on the severity of the disease, as well as the special nature of the course. of this disease.

If the patient has a blockage of the urine outflow tract as a result of a large stone, and he has only one kidney, then, accordingly, the operation should be performed immediately.

At the slightest opportunity to hope for the effectiveness of conservative treatment, surgical intervention is postponed.

Unfortunately, in rare cases it is necessary to resort to organ removal. This occurs in cases where the kidney completely stops functioning and its death is noted.

Most often, such operations are performed on patients old age, due to the fact that their regenerative functions practically do not work.

promoipochki.ru

Hydronephrosis - degrees, symptoms, treatment

The word “hydronephrosis” consists of two parts: “hydro” - water, “nephro” - kidney. That is, hydronephrosis means increased fluid content in the kidney when the normal outflow of urine is disrupted. This is a serious disease because if hydronephrosis is not treated, the affected kidney may lose its functions, which is life-threatening condition.

Types and causes of hydronephrosis

Hydronephrosis can be congenital, or primary, and acquired, or secondary. Hydronephrosis in children, as a rule, is congenital, in adults it is acquired.

The most common causes of hydronephrosis in children are congenital abnormalities of the structure of the kidney or its vessels. Secondary hydronephrosis is a consequence of changes in the structure of the kidney or urinary tract (ureter, urethra, and sometimes bladder) as a result of some disease. It could be inflammation renal pelvis or ureter, prostate adenoma, cysts and strictures (narrowing) of the urinary tract, etc.

Hydronephrosis can be unilateral, affecting only one kidney, or bilateral. Bilateral hydronephrosis occurs when the outflow of urine in the lower parts of the urinary tract - the bladder and urethra - is impaired, resulting in both kidneys suffering from increased fluid content. Hydronephrosis in children is usually unilateral.

In the case when not only the renal pelvis, but also the ureter has undergone pathological expansion under urine pressure, they speak of ureterohydronephrosis.

Degrees of hydronephrosis

There are three degrees of hydronephrosis:

  • Hydronephrosis in the first degree. Stretching of the renal pelvis (pyelectasia) occurs as a result of increased urine pressure. At this stage, the function of the kidney is not yet impaired, but the kidney is already increased in size;
  • Hydronephrosis in the second degree. There is a further, more significant expansion of the renal pelvis and renal calyces (hydrocalicosis). As a result, the fluid contained in the tubules compresses the kidney parenchyma, which thins (atrophies) under the influence of pressure. At this stage, kidney function is significantly impaired;
  • Hydronephrosis in the third degree. Atrophy of renal tissue increases, becoming irreversible. Kidney function is gradually lost, and in the final stage of hydronephrosis the kidney dies. A kidney that has lost its function in this case poses a significant threat to health.

Symptoms of hydronephrosis

The severity of the symptoms of hydronephrosis depends on the degree to which the disease occurs. Early symptoms of hydronephrosis are not pronounced, so the disease is sometimes detected in an advanced state.

Hydronephrosis in newborns, and indeed hydronephrosis in children in general, usually does not manifest itself in any way until the third degree of the disease, except that the baby’s increased anxiety may attract attention; sometimes with hydronephrosis in newborns, an admixture of blood is found in the urine. Hydronephrosis in newborns is usually known in advance, since it is detected during prenatal ultrasound diagnostics fetus Hydronephrosis in children is more than late age, as in adults, can be discovered accidentally during an examination for another reason.

Sometimes an early symptom of hydronephrosis is renal colic, this is especially true for hydronephrosis caused by urolithiasis. When the disease reaches a significant stage of development, the main symptoms of hydronephrosis are dull aching and constant pain in the kidney area and signs of reduced renal function: edema, high blood pressure due to impaired water metabolism. One of common symptoms hydronephrosis is the appearance of blood in the urine (hematuria).

Diagnosis of hydronephrosis

The leading method for diagnosing hydronephrosis is ultrasound examination of the kidneys and urinary tract. As a supplement, color Doppler mapping (CDC), radioisotope renography, and sometimes computed tomography or magnetic resonance imaging are used. Also in some cases of hydronephrosis it can be used endoscopic examination– urethrocystoscopy or ureteroscopy. All these methods are aimed at visualizing the internal structure of the kidney, ureters and the vessels supplying them.

Since hydronephrosis promotes infection, urine culture is performed. Functional tests urine (Zimnitsky test, Nechiporenko test) is carried out to study kidney function.

Treatment of hydronephrosis

Hydronephrosis is treated only surgically. Conservative treatment of hydronephrosis is used only to eliminate inflammation if a secondary infection has occurred, or as therapy to alleviate the symptoms of hydronephrosis before surgery.

Surgery to treat hydronephrosis consists of removing the obstruction that interferes with the normal flow of urine. Each case requires an individual approach, so the choice of surgical treatment for hydronephrosis remains with the surgeon. Currently, surgical treatment of hydronephrosis is performed endoscopically, which does not require a large and traumatic incision to access surgical field.

The endoscope is inserted into abdominal cavity through two small punctures, all manipulations are performed with a thin surgical instrument under the control of what is happening on the monitor. This method of treating hydronephrosis can significantly reduce the invasiveness of the operation and the risk of postoperative complications and practically bloodless.

Hydronephrosis in children early age in a minor stage may not require medical intervention. In such cases, dynamic monitoring with ultrasound examination from two to four times a year. Hydronephrosis in children of the first and even second degree sometimes goes away on its own during the first year of life, surgical treatment hydronephrosis is not required. However, the disease in the third degree, as well as the increase in symptoms of hydronephrosis in children, require urgent surgical intervention.

With hydronephrosis in terminal stage If the kidney dies, it is removed. Typically, this operation is performed in older people, when the regenerative functions of the body are significantly reduced.

Video from YouTube on the topic of the article:

The information is generalized and is provided for informational purposes. At the first signs of illness, consult a doctor. Self-medication is dangerous to health!

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Water in the kidneys

If the doctor states that water is in the kidneys, therefore, the patient is diagnosed with hydronephrosis.


Unfortunately, recently this disease has been steadily gaining momentum, due to which it is considered the most common.

Hydronephrosis can affect the kidneys of even a fetus in the womb.

A person can also acquire such a disease during his life.

  • Symptoms and causes
  • Diagnosis of hydronephrosis
  • Treatment

During normal kidney function, urine is influenced by low pressure flows out of it.

If pathology occurs, the outflow of urine becomes impossible and it fills the renal pelvis.

As a result, it becomes overfilled with urinary fluid (water), and its size increases due to forced stretching.

Long stay kidneys in this state harms it, leads to irreversible processes, damaging its tissues and causing disruption in functional activity.

Hydronephrosis can be congenital or acquired, and can affect one organ or both at the same time. There are also acute and chronic stages of development of this disease.

Hydronephrosis in an infant

Symptoms indicating the development of the disease may vary depending on how quickly the outflow of water is blocked.

If everything happens quickly and water instantly fills the renal pelvis, then the patient experiences severe, painful, sharp pains on the side of the lower back where the diseased kidney is located.

If water gradually, slowly fills them, then symptoms may not appear, the patient may not even be aware of the disease. In rare cases, aching pain may be felt in the kidneys.

In addition to pain in the kidneys, other symptoms may indicate the presence of hydronephrosis:

  • urinary tract infection;
  • increased body temperature;
  • pain during urination;
  • frequent urination;
  • blood in urine;
  • abdominal pain, nausea and vomiting.

The accumulation of water can be caused by blockage of the ducts from kidney stones.

If a person is in a situation in which this organ was injured, then blood clots can also block the path for the normal outflow of water.

The problem can also occur due to infection or surgery, resulting in excessive narrowing of the ureter.

Pathology nerve endings, responsible for the functioning of the ureter, provokes stagnation of urinary fluid in the kidneys.

Unfortunately, that's enough common cause the fact that water is not able to naturally flow out of them calmly, are cancers that affect men prostate gland, and in women - the bladder or the kidneys themselves.

Diagnosis of hydronephrosis

At the first manifestations of any abnormalities in the activity of the kidneys, especially in the presence of pain, the patient must consult a doctor.


Laboratory research

It is important not only to characterize the symptoms, but also to indicate whether the condition is aggravated by heredity.

The more complete the information provided, the easier for the doctor will understand the reasons and prescribe treatment.

Of course, a single examination is not enough in most cases, so the patient is recommended to undergo an appropriate examination.

The patient may be asked to undergo laboratory tests, including urine and blood tests.

When examining urine, attention is paid to the presence of blood, any types of infections, as well as abnormal cells.

Laboratory diagnostics

A blood test can indicate the level of concentration of white blood cells, red blood cells and platelets, identify possible excess or a deficiency of electrolytes in the blood, which are quite dangerous not only for the patient’s health, but also for his life.

The results of a blood test for creatine can assess the performance of the kidneys.

Modern medical instruments make it possible to diagnose any abnormalities in the functioning of human internal organs, including determining stagnation of water in the kidney.

CT scan allows you to finally verify the presence of a water component in the kidneys and confirm hydronephrosis. In addition, such a study allows us to understand the reason that caused this pathology.

Ultrasound examination is also effective way identifying a kidney problem.

This study is especially indicated for pregnant women in order to protect the abdomen, and, accordingly, the fetus, from exposure to radiation.

A timely detection of the problem of water stagnation in the kidney will allow you to prescribe effective treatment and avoid the progression of the disease to chronic stage.

At the first (mild) stage, the deviations are very minor, so they do not fundamentally affect the functioning of the kidneys.

The average degree of pathology is already characterized by a slight thinning of the walls of the kidneys, expansion of the pelvis and an increase in the size of the organ due to the constant pressure of retained water.

Unfortunately, already at this stage, kidney function deteriorates by almost half.

The third stage (severe) turns out to be extremely sad for many patients, since the organ almost doubles in size, the very structure of the kidneys and its functions are susceptible to irreversible changes that can lead to death.

Treatment

If the reason feeling unwell and pain in the kidney area is water, or rather its stagnation, then the doctor, when prescribing treatment, is necessarily based on the reason that led to this condition.


Surgery

Of course, attention is also paid to the degree of water stagnation in the kidneys.

But no matter what treatment is prescribed, it necessarily boils down to measures to reduce the amount of water so that the pressure on this organ is noticeably reduced and the water does not have any further impact. negative impact on its structure and functions.

Treatment is also aimed at eliminating the cause that provoked stagnation of water and the impossibility of its outflow.

Diseases of the second and third stages are generally subject not only to drug treatment, but to surgical intervention.

When the kidneys become infected, the most important thing is to quickly destroy the infection itself in order to prevent it from entering the blood, which can cause blood poisoning and sepsis.

Drug treatment, which is used for such a disease, is aimed only at reducing or eliminating pain and eliminating infections.

In any case, the first thing that is used in drug treatment is to ensure that the water leaves the kidneys as soon as possible.

In order for water to leave the kidneys and reduce pressure on them, many patients are advised to install a catheter.

It is thanks to it that nothing interferes with the outflow of urinary fluid, so the size of the kidneys decreases, and the patient almost immediately feels relief.

Therapeutic diet

Only after the pressure in the kidney has decreased, doctors begin to eliminate the cause that caused the blockage of water movement.

For this purpose, existing kidney stones are crushed using a laser or sound waves using modern equipment.

Part or all of the prostate may be removed if the cause is caused by a tumor in it. Cancers are treated using radiation or chemotherapy.

Of course, as with other diseases, patients in whom water accumulates in the kidney and increases blood pressure are recommended to adhere to a special diet.

The amount of salt should be sharply reduced, the maximum amount allowed for consumption per day should be about 2 g.

To maintain your health, it is best to avoid salty foods altogether, replacing them if necessary. lemon juice.

Vegetable salads They are quite useful, so their use is recommended for patients.

Water in large quantities in such a disease does not benefit the body, but once again overloads it, so the amount of water should be reduced and should not exceed two liters per day.

Fatty meats, smoked meats, marinades, preservation – forbidden foods, bringing only harm and deterioration of the general condition.

If after the onset of the first symptoms, the patient immediately seeks medical care and follows all prescribed recommendations, the prognosis will be very favorable, since in 95% of cases almost complete recovery is achieved.

Hydronephrosis develops at any age, including in infants. If you consult a doctor when the first clinical manifestations appear, the disease can be cured without damaging kidney function. However, if the disease is not diagnosed on time, then various consequences of hydronephrosis develop.

Among the complications that the disease leads to, the most common are:

  • Attachment of a secondary infection
  • The appearance of kidney stones
  • Spontaneous kidney rupture
  • Progressive decline in renal function with the development of renal failure.

Ultrasound examination is of greatest importance for diagnosing the disease. Moreover, with the help of ultrasound it is possible to diagnose congenital hydronephrosis of the fetus in the prenatal period.

Why do complications develop with hydronephrosis?

Hydronephrosis in literally words means fluid in the kidney. Due to the presence of an obstacle to the outflow of urine, it accumulates in the collecting apparatus. Every day the kidney increases in size, the substance of the organ atrophies and the parenchyma becomes thinner.

If the terminal phase of hydronephrotic lesions develops, then a moment comes when the walls of the organ are so thin that they cannot withstand the pressure exerted by the fluid.

Then spontaneous rupture of the kidney occurs, and all the contents pour out. Opens internal bleeding and without urgent treatment the patient will not survive. Of course, if appointed correct treatment hydronephrosis, spontaneous rupture of the kidney does not occur, because the doctor does everything possible to restore the outflow of urine and preserve the function of the organ. But complications such as inflammation and urolithiasis occur quite often, and can develop even before the first signs of hydronephrosis appear.

Bacterial complications occur when infection enters the kidney cavity upward path from other parts of the urinary system. Hydronephrosis creates favorable conditions for the proliferation of these bacteria, resulting in the development of pyelonephritis. Moreover, pyelonephritis against the background of hydronephrosis is much more severe. If surgical treatment for hydronephrosis is planned, then before this you should take a course antibacterial therapy to get rid of pyelonephritis.

Preoperative treatment of pyelonephritis is necessary because surgical interventions are not performed against the background acute diseases. Indeed, in this case, the consequences after the operation are not predictable.

Urinary stones are formed from uric acid salts and other substances that are normally excreted in the urine. Stagnation of fluid in the cups and pelvis leads to the fact that the salts settle and over time develop into stones of various sizes. These stones can move along urinary tract and, getting into the place of narrowing, completely block the lumen of the ureter. Then urine will not pass away at all and acute hydronephrosis will develop, which without emergency surgery is complicated by kidney rupture.

Why is hydronephrosis more dangerous?

The greatest danger lies in the development of chronic renal failure.

After all, urolithiasis and infectious complications can be cured, but chronic renal failure remains for life and the only method to completely get rid of the disease is to transplant a kidney.

Chronic renal failure

Chronic renal failure develops when the kidney is unable to perform its filtering function. Toxic metabolic products are not excreted in the urine, but remain in the blood, depressing the entire body. This complication is accompanied by the following symptoms:

  • Reduced amount of urine, up to its complete absence
  • Violation of general condition: headaches, weakness, increased fatigue
  • Loss of appetite, weight loss
  • Dry mouth
  • Lethargy, progressive impairment of brain function
  • Increased blood pressure
  • The appearance of a yellow tint to the skin
  • Skin itching.

The dynamics of chronic renal failure depend on the causes of hydronephrosis and the treatment provided. With the therapy started, the failure does not progress, but it is no longer possible to restore kidney function.

Treatment of hydronephrotic transformation of the kidney

Treatment of the pathology is carried out through a combination of conservative and surgical measures. Conservative treatment is aimed at eliminating the symptoms of the disease. The patient is prescribed various medicines, acting on one or another complication of hydronephrosis. After the complications are eliminated, they are discharged prophylactic drugs to restore renal function.

Surgical treatment is aimed at eliminating the cause of the disease. During the operation, the doctor restores the patency of the ureter. Thanks to this, the outflow of fluid is normalized, leaving pain syndrome, blood pressure is normalized, the amount and color of urine is restored after surgery. After the intervention, the patient remains for observation. In the hospital, regular changes of dressings, control over the quantity and quality of urine excreted, assessment of drainage discharge (mucus, blood, pus), intravenous infusion are carried out medicines.

Constant dressing changes are performed not only to assess the condition of the wound, but also to prevent the most common complication after surgery - bacterial infection.

The postoperative period lasts from 5 to 10 days, depending on the type of surgical approach used and the general condition of the patient. If the doctor sees that the patient no longer needs further observation And intravenous administration medicines, and postoperative wound is in in good condition, then you can safely send him home. The patient is scheduled for a follow-up appointment to remove sutures, assess general condition and further treatment.

Kidney transplantation: general information

Kidney transplantation is a complex and expensive operation, the main problem which consists of correct selection donor. In patients with kidney failure, the non-functioning kidney is removed and a donor organ is transplanted in its place.

Consequences after kidney transplant surgery vary. Most patients feel great and live for years without signs of complications. However, some people develop organ rejection and have to have their transplanted kidney removed. It should be noted that with the correct selection of a donor and the correct operation, complications are observed only in extreme cases.

Life after a kidney transplant involves constant use of medications, but this is still better than suffering from a disease that depresses the entire body.

In this video you can watch a story about kidney transplantation:

Kidneys are internal organs that purify the blood by removing toxic substances dissolved in urine, supporting water-salt balance body. U healthy person The kidneys do not allow excess water to be retained in the body.

A variety of reasons lead to a slowdown in the removal of fluid from the body. Fluid in the kidneys fills the calyces, creating additional load on the organ, which leads to the development of a disease called hydronephrosis.

Causes

The disease develops due to insufficient functioning of the ureteral valves, which leads to reverse flow of urine. It is not possible to determine the causes of the disease one hundred percent, but there are factors that provoke the accumulation of fluid in the kidney:

  • Water can accumulate when the ducts are blocked by kidney stones.
  • Blood clots formed during kidney injury can also become an obstacle to the drainage of water.
  • Impairment of water outflow can occur when the ureter narrows as a result of surgery.
  • and ureters.

Symptoms

Hydronephrosis can be congenital or acquired. The disease may affect one or two kidneys. The disease can occur in acute or chronic form. Signs of the disease depend on how rapidly the exit of water from the body is blocked. With rapid overflow of the renal pelvis, the patient feels severe pain in the lumbar region, on the side where the inflamed organ is located.


Low back pain is one of the characteristic symptoms hydronephrosis

When the kidneys slowly fill with water, the manifestation is often pain symptoms not felt. The development of hydronephrosis is indicated by signs: increased temperature, frequent urination, and the presence of blood traces in the urine. Abdominal cramps, nausea ending in vomiting, fatigue, and a decrease in daily urine volume occur.

Stages of the disease

Urology distinguishes 3 stages of hydronephrosis:

  • Stage 1. Minor. The kidney performs its functions one hundred percent.
  • Stage 2. The pelvis expands significantly. The fluid puts pressure on the parenchyma, causing the tubules to close. The functions of the kidney are only half performed.
  • Stage 3. Complete atrophy of kidney tissue. The irreversibility of the process leads to the death of the kidney and a mortal threat to the patient.

Diagnostics

Hydronephrosis must be diagnosed at an early stage, when the disease is recognized at late stages Therapy will not help - irreversible processes will occur. The history of the disease includes the manifestation painful sensations in the kidneys, lumbar region.

During a conversation with a doctor, it becomes clear whether there have been surgical interventions on the pelvic organs, neurological diseases, since neurogenic disorders are often the cause of kidney pathologies. Visualization methods play a decisive role in diagnosing the disease, making it possible to consider dangerous changes in the kidney and adrenal glands.

Ultrasound determines the size, shape, and weight of the kidney. Detects stones, cysts and other pathologies. The study helps to identify the causes of hydronephrosis.


Ultrasound examination for kidney pathology is mandatory

MRI

The most informative diagnostic procedure, with the help of which three-dimensional and two-dimensional images of organs are created, which makes it possible to determine the stage of the disease and changes in tissues.

Vaccine cystourethrography

A diagnostic procedure is used to evaluate the condition of the urinary system. Images on x-rays indicate the presence of reverse flow of urine. Detects the presence of vesicouriteral reflux. The procedure is performed by inserting a catheter.

Excretory urography

An X-ray examination performed when a special substance is introduced into the body, which allows one to clearly examine the structure of the kidneys. The method reveals changes in the structure of the organ and makes it possible to assess the condition of the excretory system of the kidneys.

Urodynamic study

The method is used to measure the pressure inside the bladder. The measurement is carried out in three options:

  • with an empty bubble,
  • when filled,
  • when the bladder empties.

Laboratory methods

In addition to instrumental diagnostic methods for hydronephrosis, blood and urine are required to be examined. Blood is taken from general analysis, urine is examined using the Nechiporenko method, and bacteriological studies are also performed.

Treatment

Conservative treatment exists for a limited number of patients and is used only when there are contraindications to surgery. Conservative therapy represents antibacterial treatment, which is assigned if there is infectious-inflammatory a process often associated with hydronephrosis.

Symptomatic therapy helps relieve pain and normalize blood pressure. Positive effect from the use of drugs – improvement of microcirculation in the kidney.

An effective treatment is an operation performed using one of two methods: organ-preserving or organ-carrying. Organ-saving surgery is chosen in cases where a kidney that has lost its function cannot be saved (development purulent process), perform a nephrectomy, a prerequisite for which is normal functioning second organ.


Surgery for fluid in the kidney is the only way to rid the patient of the pathology

Other surgical options are:

  • Resection of a narrowed section of the ureter.
  • Resection of the pelvis.
  • Removal of the narrowed section of the ureter, after which urethrocalicoanastomosis is performed.

Urethrocalicoanastomosis is performed if the pelvis is located intrarenally: it is cut off from the damaged tissue of the ureter and sewn into the lower cup. A similar operation is performed if the ureter is narrowed in the lower section - part of the ureter is excised and transplanted to a new place in the wall of the bladder. Ureterolysis is carried out if the ureter is compressed by scars - adhesions are removed.

Traditional medicine in the treatment of hydronephrosis

Folk remedies are used to treat hydronephrosis as an addition to drug therapy subject to mandatory medical supervision. Verified folk recipes Further.

Recipe 1. Mix dry herb:

  • Knotweed – 1 tbsp. spoon.
  • Horsetail – 1 tbsp. spoon.
  • Bean shells – 1 tbsp. spoon.

Add 5 tablespoons of birch leaves. 2 tbsp. Place spoons of the mixture into a thermos and pour 200 ml of boiling water. Leave for 7 hours. Drink in 2 doses 20 minutes before meals.

Recipe 2. Take in equal proportions:

  • Adonis,
  • oat grains,
  • hop cones.

2 tbsp. spoons of the mixture are poured with 1 glass of boiling water, leave for 7 hours. Drink in 2 doses 20 minutes before meals.

Fluid in the kidneys in children

Hydronephrosis in children is more often a congenital pathology in which the kidney cavity is affected, impairing the patency of urine. There are 2 types of the disease: unilateral and bilateral. If one kidney is damaged, the child may not feel any manifestations of the disease, since the second kidney takes over all the functions of the affected one.

Bilateral pathology causes dangerous consequences in the child, up to fatal outcome from uremia. Congenital form Fluid in the kidneys is diagnosed more often, in most cases in a maternity hospital.

Important! Research intrauterine child reveals pathology even before the baby is born.


Diagnosis of older children is similar to studies in adults

Treatment of hydronephrosis in a child is possible only surgically. At early diagnosis Children tolerate surgical intervention well, rehabilitation takes place in a short time.

Hydronephrosis during pregnancy

Hydronephrosis often appears in expectant mothers due to physiological changes caused by pregnancy. The cause of the disease is compression of the ureter by the enlarged uterus. In pregnant women, the right organ is most often affected by hydronephrosis. Hydronephrosis in pregnancy has the ability to resolve without treatment after the birth of the child.

This pathology is not an indicator for abortion; doctors call it true hydronephrosis of pregnancy. If a woman develops chronic hydronephrosis during pregnancy, this threatens severe complications during childbirth. Prevention of hydronephrosis - prevention and timely treatment of diseases that cause fluid in the kidney, general strengthening protective forces body.

Hydronephrosis or the accumulation of water in the kidneys is a pathology in which the renal collecting system expands, leading to parenchymal atrophy. Being a serious disease, hydronephrosis without timely treatment will lead to the need for surgical intervention. Violation of the outflow of urine does not appear immediately, so it is extremely important to recognize the symptoms of the disease in time and begin prevention and therapy as early as possible.

Hydronephrosis: definition, classification of pathology

Hydro - water, nephro - kidney, translated from Latin the translation of the name of the disease speaks for itself: the concentration of fluid at a local point. Moving into the acute stage, the pathology leads to the destruction of renal functions, disruption of metabolic processes and infection of the patient’s entire body.

The disease can be diagnosed immediately after birth - a congenital variant or during life - acquired. The pathology can affect one or both kidneys, while bilateral inflammation disrupts the outflow of urine in the lower reaches of the urinary tract: the ureter, urethra.

The disease is classified into three degrees:

  1. The first degree is manifested by a slight expansion of the pelvis due to increased pressure on its walls. At the same time, the organ still retains 100% of its functions.
  2. The second degree is a moderate or significant expansion of the pelvis and cups. The accumulated fluid in the kidneys puts pressure on the parenchyma, blocks the tubules, the functionality of the organs is preserved by 40-45%;
  3. The third degree is characterized by atrophy of organ tissue, and the process is already irreversible, leading to complete death of the kidney and a threat to the patient’s life.

Causes of the disease


Doctors find it difficult to determine the causes of the disease with 100% probability, but there are many factors that provoke the accumulation of fluid in the paired organ:

  1. Obstructions and/or genetic disorders of the direct flow of urine formed in the ureter, bladder;
  2. Insufficient functionality of the ureteral valves, leading to reverse flow of urine.

Important! Congenital hydronephrosis has the following main diseases: dysthenesia, abnormal development of the urinary system, obstruction. The acquired disease basically contains urolithiasis, benign/malignant neoplasms, and other urological pathologies

Symptoms of hydronephrosis


At the first stage, it is difficult to notice the disease. Aching pain in the lower back, fatigue is written off as a common malaise. However, it is these nonspecific symptoms, as well as a decrease in daily urine volume, that should alert the patient. A clear clinical picture appears towards the end of the second, in the third stage, when blood appears in the urine. Hematuria is noticeable to the naked eye, and in combination with constant local pain, the symptoms directly indicate problems with the kidneys - you cannot put off a visit to the doctor!

Important! In young children, hydronephrosis can be diagnosed during the period of intrauterine fetal development. In this case, parents are warned in advance about what measures will have to be taken to prevent and treat the disease.

Detection of pathology at an early stage is a big coincidence, but if the patient notices signs of renal colic:

  • Pain when urinating;
  • Fluctuations in temperature, blood pressure;
  • Constant dull aching pain in the lower back with “recoil” to the groin;
  • Nausea, headache, vomiting;
  • General weakness, anemia;
  • Blood in the urine;
  • Frequent urge to urinate with a decrease in the total daily volume of urine;
  • Swelling of the arms, legs, face.

You need to see a doctor as quickly as possible - these signs directly indicate the progression of hydronephrosis.

Important! Due to neglect, the pathology often leads to rupture of the renal pelvis. Very expensive treatment and removal of the organ will be required to prevent the infection from spreading throughout the body.

Complications


The worst outcome of the disease is kidney failure. The organs completely refuse to function, and the patient remains tied to a hospital bed. Blood filtration is not performed, which means contamination with metabolic products occurs, which leads to infection and death.

Urolithiasis is another complication. If an infection is associated with the formation of stones, the pathology is aggravated by additional diseases and long-term, expensive treatment will be required to restore kidney function and relieve infectious diseases.

Diagnosis and treatment


Hydronephrosis of the kidneys is a concomitant pathology, therefore, without treating the underlying disease, all efforts will be ineffective. To diagnose the disease, the specialist, in addition to collecting anamnesis, invites the patient to undergo a full comprehensive examination:

  • general urine and blood tests;
  • Ultrasound of the kidneys, which helps determine the size and dynamics of the disease;
  • x-ray of organs to view enlarged pelvis;
  • radioisotope scanning to determine the degree of impairment of functionality.

CT, MRI, angiography may also be offered. All procedures are important for making the correct diagnosis and selecting treatment. Conservative methods often do not give the desired result and, as a rule, are used as a preparatory stage for surgery: to reduce pressure in the kidneys and reduce the intensity of the inflammatory process.

Surgery is the main path to healing. Today, surgeons prefer reconstructive techniques that preserve the organ. The choice of options is large and it all depends on the patient’s age, clinical picture and dynamics of the pathology.

Important! Nephrectomy is performed only in case of complete damage to the parenchyma, loss of functionality and a high threat to the patient’s life. Most often, complete removal of an organ occurs in older people.

At an early stage of the disease, therapeutic methods, maintaining a diet, regular examination and prevention of pathology are sufficient. If the doctor’s recommendations are followed, the disease is reversible and in 86% of cases patients do not experience negative manifestations of the disease.

Diet therapy and drinking regimen

Despite the simplicity of the advice, diet therapy, coupled with adherence to a drinking regime and a healthy lifestyle, can significantly reduce the symptoms of the disease, and then serve as an excellent prevention of pathology. When choosing a menu, it is better to avoid fatty, heavy dishes, giving preference to raw vegetables and fruits.

The volume of fluid consumed for a patient without additional diseases is at least 2-2.5 liters per day. The doctor will explain the details of the diet: the diet is selected individually, however, reducing the amount of spicy, sweet, and smoked foods will only come in handy, as will giving up alcohol, strong coffee, and tea. Dishes introduced into the diet should be rich in amino acids, which are not synthesized by the body, but are obtained only from foods.

Important! Limiting or completely eliminating table salt is a mandatory part of the diet for hydronephrosis. A potato-egg diet with a reduced calorie content and high levels of amino acids is considered the most suitable. In addition, the products do not increase the load on the gastrointestinal tract, remove excess cholesterol well and are processed by the body of a patient of any age. You cannot keep this diet for a long time! The timing of nutrition will be advised only by a highly specialized doctor, whose consultation is required.



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