How is hydronephrosis detected?

Written by Li Liu Sheng
Nephrology
Updated on December 12, 2024
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The kidneys have a very strong compensatory ability. In the early stages of hydronephrosis, the amount of fluid may not be large, or the duration may not be long, and usually, the patient may have no symptoms. Hydronephrosis is often discovered during health examinations or through ultrasound or CT scans performed during hospital stays.

Of course, if the hydronephrosis persists for too long and the volume is very large, the patient can gradually feel discomfort or a distended sensation in the lower back or upper abdomen. Moreover, if the hydronephrosis is caused by kidney stones, the patient often experiences severe back pain, and there might even be visible blood in the urine.

Hydronephrosis can also lead to symptoms of urinary tract infections such as frequent urination, urgent urination, and painful urination. Prolonged hydronephrosis can lead to a decline in kidney function, resulting in symptoms like fatigue, loss of appetite, and poor overall health. Therefore, it is crucial for patients to undergo regular ultrasound examinations of the kidneys to detect hydronephrosis early.

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Nephrology
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What is the best treatment for hydronephrosis?

The so-called hydronephrosis often occurs due to some factor blocking the urinary system, causing urine to not be excreted normally. The most common cause is urinary system stones, but it can also be due to issues like tumors or benign prostatic hyperplasia. The treatment for stones depends on the size of the stone. Stones smaller than 5 millimeters in diameter can often pass naturally. If the stone is 7 to 15 millimeters in diameter, extracorporeal shock wave lithotripsy is typically used. If stones in the lower mid-ureter do not respond well to medication, retrograde removal under cystoscopy can also be performed. For some patients who have had a long-standing obstruction, renal function may already be impaired. If the obstruction cannot be relieved, surgeries such as creating a urinary diversion can be performed. This includes procedures like bladder fistulation, pyelostomy, or percutaneous ureterostomy, among others.

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What department to see for hydronephrosis?

Patients with hydronephrosis should visit the urology department of a formal hospital, because the conditions causing hydronephrosis are often surgical in nature. The most common cause is urological stones, which block the ureter or the bladder opening, causing urine to accumulate within the urinary system and leading to hydronephrosis. Additionally, patients with benign prostatic hyperplasia may also experience this condition. Tumors in the urinary system may compress the ureter and cause hydronephrosis. Some patients have congenital deformities of the ureter, where changes in the anatomical structure can lead to hydronephrosis. In summary, these conditions often require surgical treatment, thus necessitating consultation at a formal hospital's urology department.

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Does hydronephrosis cause pain?

Patients with hydronephrosis do not all experience pain. In fact, only a minority of patients experience pain. Hydronephrosis is caused by some form of urinary obstruction, such as urinary system stones, tumors, or problems like prostate enlargement, which prevent urine from being excreted smoothly. In this case, the accumulation of fluid can be a long-term, gradual buildup. Patients often adapt to the progression of the condition and do not exhibit obvious symptoms, especially in the early stages. However, some patients may experience pain, such as those with urinary system stones, or pain may occur when a tumor ruptures.

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Should people with hydronephrosis avoid certain foods?

Although there are many causes leading to hydronephrosis in patients, most hydronephrosis is related to stones, meaning that hydronephrosis occurs in patients due to ureteral kidney stones. Therefore, dietary restrictions are necessary for patients with hydronephrosis in daily life. If the hydronephrosis is caused by calcium oxalate stones, patients should avoid consuming foods that are high in calcium and oxalates, such as nuts, legumes, spinach, and beets. If the hydronephrosis is due to the formation of uric acid stones, patients should also avoid consuming excessive amounts of animal organs, such as pork liver and kidneys, avoid seafood, and try not to drink beer, as these contain a high amount of purines, which can easily lead to stone formation. Additionally, if patients with hydronephrosis also have renal insufficiency, they should follow a low-salt diet and avoid consuming particularly salty foods, including various pickles, etc.

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Causes of hydronephrosis

The so-called hydronephrosis often occurs because there is some factor in the patient's kidney or ureter that prevents the urine from being excreted smoothly, causing fluid accumulation and dilation in the renal pelvis, renal calyx, and ureter. The causes of this obstruction are often mechanical, such as urinary system stones, tumors, urinary tract deformities, or compression of the ureter caused by enlargement or tumors in nearby organs of the urinary system. In a few cases, it may also be related to a decline in the function of the ureter itself, such as a neurogenic bladder, ureteral reflux, or decreased ureteral motility.