Hydronephrosis (swollen kidneys): symptoms, causes, treatment

Definition

What is hydronephrosis?

Hydronephrosis is a condition when the kidneys become swollen. The kidneys can become swollen due to failure to drain urine into the bladder. As a result, urine accumulates in the kidneys.

Generally, swelling only occurs in one kidney (unilateral hydronephrosis). However, it is possible that this condition can affect both kidneys (bilateral hydronephrosis).

The main function of the urinary tract is to remove food and fluid from the body. The urinary tract consists of four main parts, namely the kidneys, urethra, bladder and urethra.

Urine is formed when the kidneys filter the blood and remove food waste and excess fluid. Urine then collects in the renal pelvis and then flows through the urinary tract to the bladder. Urine in the bladder is excreted from the body through the urethra.

If something blocks the flow of urine or urine back into the pelvis from the bladder (vesicoureteric reflux), kidney swelling can occur.

Hydronephrosis is not a disease, but a syndrome that occurs due to other underlying diseases. If not treated immediately, several health problems can occur, such as kidney disease or permanent kidney failure.

How common is this condition?

Hydronephrosis is a fairly rare condition. However, swollen kidneys can occur in almost anyone of any age group. When viewed by sex, the difference in new cases becomes clear when entering the age of 20.

In the age range of 20-60 years, this condition is more common in female patients than male. This may be related to pregnancy or a problem with the female reproductive system.

In addition, in men aged 60 years and over, the number of cases of this condition has increased. This may be caused by a disease related to the prostate gland.

Swelling of the kidneys can be treated by recognizing the existing risk factors. You can consult a doctor to find out more information about this disease.

Signs & symptoms

What are the signs and symptoms of hydronephrosis?

At first, people with hydronephrosis may not feel any obvious signs or symptoms. However, over time, symptoms can appear when the swelling gets worse, causing discomfort.

This can occur because the kidney which is filled with urine can put pressure on other organs and is influenced by how long the blockage has occurred can affect the symptoms that arise.

The signs and symptoms of hydronephrosis will vary from person to person, depending on the cause and severity. Here are some signs and symptoms that may appear if your kidneys are swollen.

• urinating less frequently,
• urine is not as much as usual,
• blood in the urine (hematuria),
• often unable to hold urine,
• pain in the back, stomach, or side of the body,
• pain when urinating,
• fever, as well
• nausea and vomiting.

Signs and symptoms of swollen kidneys in babies

Apart from adults, kidney swelling can also occur in babies. Although most cases do not show any symptoms, there are some signs that parents may need to watch out for, such as:

• pain in the stomach or side of the body,
• blood in the urine (hematuria),
• fever,
• cranky, easy to cry for no reason,
• looks less enthusiastic,
• the stomach looks swollen, and
• decreased appetite.

There may also be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor immediately.

When should I see a doctor?

If you feel the symptoms mentioned above, or other unusual signs appear, consult a doctor immediately.

In addition, you also need to watch out for symptoms of urinary tract infection (UTI). The reason is, problems with the urinary tract can cause UTIs. This is why UTI is one of the most common complications of hydronephrosis.

The reaction of each person's body to the symptoms of a disease may vary. Therefore, you should always check your symptoms with your doctor to get treatment according to your condition.

Cause

What causes hydronephrosis?

The most common cause of swollen kidneys is a blockage in the urethra. The condition can occur suddenly and is usually caused by kidney stones or blood clots.

If the urethra or ureter becomes blocked, the flow of urine can reverse towards the kidneys (vesicoureteric reflux), causing swelling to occur.

In addition, there are various conditions that cause hydronephrosis as reported by the National Kidney Foundation, namely:

1. Cancer

Tumors in the bladder, prostate gland, uterus, or other organs located around the urinary tract can block urine flow.

2. Benign prostate enlargement

Benign prostate enlargement (BPH) is a common condition that occurs in older men. Swelling of the prostate can cause obstructed urine flow.

3. Blood clots

Blood clots or clots in the kidneys or urinary tract can also affect urine flow.

4. Narrowing of the urethra (urethral stricture)

Urethral stricture is a condition caused by injury, infection, or non-infectious inflammation. If this condition occurs, there will be a problem in the urine disposal process.

5. Congenital kidney disease

Congenital kidney disease or multicystic kidney disease occurs when the kidneys malfunction due to a cyst. If a kidney cyst develops, it can affect the flow of urine and cause swelling of the kidneys.

6. Problems with the nervous system

If there is a disturbance in the nervous system around the bladder and urinary tract, urine flow will also be disturbed.

Risk factors

What increases my risk for hydronephrosis?

Hydronephrosis is a disease that can affect anyone, regardless of age or race. However, there are several factors that can increase a person's risk of developing this disease.

Keep in mind that having one or more risk factors does not mean that you will definitely be exposed to a disease. In rare cases it is possible for the disease to appear in the absence of any risk factors.

Here are some things that can put a person at risk for kidney swelling caused by a buildup of urine.

1. Age

In both adults and infants, kidney swelling can occur. However, most cases show the patient is in the age range of 20-60 years.

2. Gender

In the age range of 20-60 years, cases of hydronephrosis are more common in patients of the sex than in men. If you belong to that age group and are sexually female, your risk is greater.

3. Suffering from kidney stones

If you have kidney stones, this condition can affect the process of removing urine from the body. This makes people with kidney stones also at risk of developing kidney inflammation

4. Congenital defects from birth

Some people are born with defects from birth. This may affect the urinary tract and kidneys, thereby increasing the risk of swollen kidney disease.

5. Have had an injury or surgery

Injury due to accidents or trauma after surgery can actually increase the potential for a person to have swollen kidneys.

6. Have a tumor or cancer

Patients with tumors or cancer, especially those that develop in the organs around the urethra, may need to be more vigilant. The reason is, tumors or cancer in the bladder, cervical cancer, or prostate cancer are more at risk of developing hydronephrosis.

Diagnosis & treatment

How is hydronephrosis diagnosed?

If you feel the signs and symptoms that have been mentioned, consult a doctor immediately. Initially, you may be referred to a urologist for a series of tests and examinations.

1. Basic physical examination

The first thing a doctor does when diagnosing a disease, including hydronephrosis, is a thorough examination. They will ask about symptoms experienced and medical history while doing a physical examination.

This is also done along with checking the stomach and around the waist to see if the kidneys are really swollen. In some cases, the doctor may need to insert a catheter to drain urine from the bladder.

2. Imaging tests

If the catheter insertion procedure is unsuccessful, it means that there is a blockage in the bladder or urethra. This makes imaging tests, such as ultrasound tests or CT-scans necessary to diagnose hydronephrosis.

This examination aims to see if your kidneys are swollen and where the obstruction is located accurately.

3. Urine test

The urine sample from the patient will be analyzed in the laboratory to check for blood, crystal stones, or bacteria in the urine.

4. Blood test

This kidney function examination aims to see creatinine, kidney filtering rate (GFR), and blood urea nitrogen.

How is hydronephrosis treated?

Hydronephrosis is generally treated by treating the underlying cause, such as kidney stones or an infection.

Some cases of kidney swelling can be resolved without surgery. However, when the disease gets worse, here are some treatment options that can be done to treat hydronephrosis, based on your health condition.

1. Usage stent to the kidneys

If the disease is categorized as acute or occurs suddenly, medical personnel will include stent or small tubes from the skin to the kidneys. This tube then helps drain the urine that has accumulated in the kidneys.

2. Lithotripsy

In this procedure, medical personnel will usually send a high-power shock wave with the help of a machine. These waves help break down the stones in the kidneys. That way, the rock fragments will dissolve and can be removed from the body.

3. Ureteroscopy

Ureteroscopy generally uses a special thin tube that will be placed in the urethra. This thin tube aims to make it easier for the doctor to crush and remove the clogged stones.

This procedure is usually combined with other methods, such as pulsed dye laser or lithotripsy. Most cases suggest that ureteroscopy is used as an alternative for pregnant women, patients with blood clots, or patients who are obese.

4. Administration of antibiotics

If hydronephrosis is caused by an infection, you may be given antibiotics to treat the cause.

5. Operation

If the stones in the kidney are too large and difficult to remove, your doctor may recommend a surgical procedure or surgery. In addition, surgery is also recommended for those of you who have tumors.

Home remedies

What lifestyle changes or home remedies can I take to treat hydronephrosis?

Medicines and treatment from a doctor are not enough, so you need to change your lifestyle to be healthier. What is needed?

1. Fulfill daily fluid needs

Meeting its fluid needs by drinking plenty of water can help the body flush bacteria from the urinary system. Therefore, it is recommended that you drink at least eight glasses of water per day.

If you are a patient with kidney disease, please consult your doctor about how much water you need to drink as needed.

If your baby or child has swollen kidneys, encourage them to drink lots of fluids. Apart from plain water, you can also make fresh juices or cold herbal teas.

However, try to avoid sodas or acidic juices as they can cause pain and irritation in the bladder.

2. Eat foods that contain lots of water

Foods that contain lots of water, such as parsley and watermelon, can actually help improve urine flow. This is what makes the stones pass out of the urinary tract more smoothly.

In addition to the two things above, you may be advised to reduce protein and high-salt foods. This is done to maintain healthy kidney function.

If you have any questions, please consult with your doctor to find the right solution for you.