How is hydronephrosis diagnosed?

Written by Zhou Qi
Nephrology
Updated on January 09, 2025
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Strictly speaking, hydronephrosis cannot be considered an independent disease; it is merely a descriptive term in imaging, and is the result of many causes and various etiologies. It occurs because urine produced by the kidneys cannot smoothly pass through the ureters and bladder to be excreted from the body, leading to fluid accumulation in the renal pelvis and calyces. This may be caused by prostate enlargement, tumors in the urinary system, urinary system stones, or chronic inflammation and scarring of the ureters. Generally, hydronephrosis can be detected through imaging techniques, including urinary system ultrasound or CT, which can confirm the diagnosis.

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Urology
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How to relieve pain from hydronephrosis

Hydronephrosis accompanied by pain is generally caused by kidney stones lodged in the ureter leading to renal colic, and the stones in the ureter can cause urinary obstruction, thus presenting as hydronephrosis. To alleviate the pain in such cases, treatment methods are chosen based on the size of the stone. If the kidney stone is relatively small and estimated to be able to pass by itself into the bladder, temporary use of pain relief medication can be administered for symptomatic treatment, along with medication that dilates the ureter to expand its diameter, facilitating the expulsion of the stone. If the stone is large and predicted not to pass on its own, temporary symptomatic treatment with pain relief medication can be used. Meanwhile, after completing preoperative examinations, surgery can be performed to remove the stone, which can also completely alleviate the pain symptoms.

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Urology
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What foods can be eaten with hydronephrosis?

Patients with hydronephrosis should pay attention to a light diet, eat more fresh vegetables and fruits, avoid spicy and stimulating foods, and consume less high-salt foods, while also abstaining from alcohol. Besides controlling their diet, patients with hydronephrosis should also actively search for the underlying causes of the condition. Common causes of hydronephrosis in clinical practice include urinary tract stones or prostate hyperplasia, mainly due to obstructions in the ureter or urethra, preventing the urine produced by the kidneys from being excreted, which then leads to hydronephrosis. Once the cause of the urinary obstruction is identified, it is necessary to actively treat the underlying cause to restore the patency of the urinary tract. After the condition improves, it is also important to drink more water and urinate frequently to maintain health.

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Nephrology
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What should I do if I have hydronephrosis and atrophy?

Hydronephrosis leading to kidney shrinkage indicates that the condition has persisted for a long time. Long-term hydronephrosis places significant pressure on the kidneys, which in turn compresses the kidney tissues causing tissue shrinkage. The destruction and shrinkage of tissues result in the kidneys' inability to function properly, leading to azotemia. Patients will experience chronic kidney failure, a situation that is difficult to reverse. Even if surgery is performed to relieve the obstruction and allow urine to be excreted, the damaged kidney tissue cannot regenerate. Therefore, it is still necessary to relieve the obstruction as soon as possible to avoid further damage to the remaining kidney tissue. For patients who have progressed to uremia, it may be necessary to consider hemodialysis or peritoneal dialysis, or undertake a kidney transplant to sustain life.

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Is hydronephrosis scary?

Hydronephrosis is rather alarming, as it harms the body in two main ways: First, it creates increased pressure inside the kidneys due to fluid accumulation in the urinary system. This pressure can compress kidney tissue, and if not resolved, may lead to irreversible kidney damage and renal failure. However, if hydronephrosis formed in the short term is quickly addressed by clearing the urinary system, it typically has minimal impact on kidney function. Another aspect relates to the causes of hydronephrosis, some of which are complicated issues, such as bladder cancer, rectal cancer, or cervical cancer in females. These cancers can press on the ureter, leading to hydronephrosis. Other causes, such as urolithiasis or benign prostatic hyperplasia, are relatively easier to manage.

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Is hydronephrosis with hematuria serious?

Whether hematuria in patients with hydronephrosis is serious cannot actually be determined by the amount of blood in the urine. It is important to identify the cause and assess kidney function, because hydronephrosis can lead to serious consequences, mainly kidney failure. If the hydronephrosis persists for a long time, it can compress the renal cortex and cause kidney shrinkage, leading to chronic kidney failure. The dangers of hematuria mainly include: first, it may cause significant bleeding, leading to anemia. Second, this type of hematuria could be caused by certain conditions, such as bleeding caused by a tumor in the urinary system, which is quite serious. Whereas bleeding caused by urinary tract infections or urinary system stones, in terms of the nature of the cause, is not considered very serious. However, significant bleeding can also lead to severe anemia and even shock, which would be more serious.