Hydronephrosis (cont.)

If hydronephrosis remains untreated, the increased pressure within the kidney may decrease the ability of the kidney to filter blood, remove waste products, and make urine as well as regulate the electrolytes in the body. Hydronephrosis can lead to kidney infections (pyelonephrosis), sepsis, and in some cases, complete kidney function loss or death. Kidney function will begin decreasing almost immediately with the onset of hydronephrosis but is reversible if the swelling resolves. Usually kidneys recover well even if there is an obstruction lasting up to 6 weeks.

The term acute hydronephrosis may be used when after resolution of the kidney swelling, kidney function returns to normal. Chronic hydronephrosis may be used to describe the situation where kidney function is lost even if the obstruction and swelling have resolved.

Since hydronephrosis is a situation that occurs because of an underlying cause, prevention depends upon avoiding the underlying cause. For example, individuals with kidney stones that cause ureteral obstruction and hydronephrosis may try to decrease the chance of a recurrent stone by keeping well hydrated.

• Hydronephrosis describes swelling of the kidney with the inability of urine to drain from the kidney into the bladder.
  
  
• Hydroureter describes swelling of the ureter, the tube that connects the kidney to the bladder.
  
  
• The obstruction may occur at any level in the urinary collecting system from the kidney to the ureter to the bladder to the urethra.
  
  
• Depending on the level of the cause, hydronephrosis may be unilateral involving one kidney or bilateral involving both.
  
  
• The increased pressure caused by hydronephrosis potentially can compromise kidney function if it is not relieved in a reasonable period of time.
  
  
• Symptoms of hydronephrosis depend upon whether the swelling occurs acutely or progresses more gradually. If it is an acute obstruction, symptoms may include writhing pain, nausea, and vomiting.
  
  
• Treatment of hydronephrosis and hydroureter is aimed at restoring urine flow from the affected kidney.

REFERENCES:

eMedicine.com. Hydronephrosis and Hydroureter.
<http://emedicine.medscape.com/article/436259-overview

Mulhollad MW, et al. Greenfield's Surgery Scientific Principles and Practice.  4th edition 2006 Lippincott Williams and Wilkins.

WebMd.com. Kidney Stones - Treatment Overview
<http://www.webmd.com/kidney-stones/kidney-stones-treatment-overview>

Last Editorial Review: 4/5/2010

Source: MedicineNet.com
http://www.medicinenet.com/hydronephrosis/article.htm