What is Hydronephrosis?
Hydronephrosis is a condition where one or both kidneys become swollen due to a buildup of urine. This happens when there is a blockage or obstruction in the urinary tract that prevents urine from draining into the bladder as it should. Over time, this pressure can damage the kidney if not treated.
Hydronephrosis is not a disease itself but rather a sign of an underlying issue in the urinary system.
What causes Hydronephrosis?
Hydronephrosis can occur due to various reasons, depending on whether the blockage is sudden (acute) or develops over time (chronic). Common causes include:
- Kidney stones
- Urinary tract infections (UTIs)
- Enlarged prostate (in men)
- Tumors in or near the urinary tract
- Congenital abnormalities (in newborns or children)
- Pregnancy, due to pressure on the urinary tract from the growing uterus
- Scarring or narrowing of the ureter
Who is at risk?
- People with a history of kidney stones or frequent UTIs
- Men over age 50, due to prostate enlargement
- Pregnant women
- Infants or children with congenital urinary tract abnormalities
- Individuals with cancers affecting the bladder, uterus, or colon
What are the symptoms of Hydronephrosis?
Symptoms may vary depending on the cause and whether one or both kidneys are affected. Some people have no symptoms, especially in mild cases.
Common symptoms include:
- Pain in the side or back (flank pain)
- Abdominal pain or swelling
- Nausea and vomiting
- Frequent or painful urination
- Fever and chills (if infection is present)
- Blood in the urine (hematuria)
- Reduced urine output or difficulty urinating
In infants, hydronephrosis may be discovered before birth during a routine ultrasound.
How is Hydronephrosis diagnosed?
Diagnosis typically involves:
- Physical examination and medical history
- Ultrasound to check for kidney swelling
- CT scan or MRI to locate the blockage
- Urinalysis to detect infection, blood, or abnormal substances
- Blood tests to assess kidney function
- In infants, prenatal ultrasound can detect the condition before birth
How is Hydronephrosis treated?
Treatment depends on the underlying cause, severity, and whether there is infection or kidney damage.
Mild cases
- May only require observation and follow-up imaging
Infections
- Treated with antibiotics
Kidney stones
- May be passed naturally or removed using medication, sound waves (lithotripsy), or surgery
Enlarged prostate or tumors
- May require medications, procedures, or surgery to relieve the obstruction
Severe cases
- A catheter or stent may be placed to drain urine
- In rare cases, surgery is needed to correct structural issues or remove obstructions
What are the complications of Hydronephrosis?
If left untreated, hydronephrosis can lead to:
- Kidney damage or failure
- Recurrent urinary tract infections
- High blood pressure
- Sepsis if infection spreads to the bloodstream
Prompt treatment usually prevents long-term complications.