Is hydronephrosis of the second degree severe?

Written by Li Yuan Wei
Urology
Updated on March 06, 2025
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Hydronephrosis grade two, this "grade two" is likely a classification used in ultrasound or CT imaging. For hydronephrosis, the presence of condition itself indicates that the pathology has already affected kidney function. The most common causes include ureteral obstruction, or obstruction at the renal pelvis exit, typically due to stones or tumors, or narrowing caused by plastic tubes. Once hydronephrosis occurs, these conditions have already altered kidney function, necessitating further diagnosis to identify the cause, with surgery possibly being required. The most common objective assessment is a CT scan of the urinary system, with enhanced CT being the most accurate for understanding the severity of the hydronephrosis. Also, it helps identify the location of the ureteral obstruction, and thirdly, it can help ascertain the cause and provide treatment.

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Written by Li Liu Sheng
Nephrology
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How is hydronephrosis detected?

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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Written by Zhou Qi
Nephrology
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What should I do about hydronephrosis?

Hydronephrosis is merely a consequence of urinary system diseases, indicating that the urine produced by the kidneys cannot be normally transported through the ureter to the bladder due to narrowing, adhesion, scarring, or obstruction somewhere. This causes the urine to accumulate in the renal pelvis and calyces. Therefore, the treatment of this disease requires identifying the cause, and then selecting a surgical treatment plan based on the situation. For instance, urinary system stones can cause hydronephrosis, and patients might need extracorporeal shock wave lithotripsy or open surgery for stone removal. Tumors in the urinary system can lead to hydronephrosis, and prostate hyperplasia can also cause similar symptoms, necessitating open surgery to resolve the obstruction. Some patients have congenital abnormalities, adhesions, or scars in the ureter, which might require surgical corrections of the ureter.

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Written by Li Liu Sheng
Nephrology
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Is hydronephrosis of both kidneys serious?

Clinically, bilateral hydronephrosis is serious, as it can lead to expansion of the renal pelvis. Long-term bilateral hydronephrosis can compress the renal parenchyma, leading to the development of chronic obstructive nephropathy, and thus cause chronic renal failure. Additionally, because urine cannot be expelled from the body in a timely manner in bilateral hydronephrosis, it is easy to combine with bacterial infections, which can lead to acute pyelonephritis. Patients may experience chills, fever, and severe back pain, as well as hematuria and general fatigue. Therefore, it is essential to identify the cause of bilateral hydronephrosis and treat it based on the nature of the hydronephrosis. Usually, the causes of bilateral hydronephrosis are related to stones, but tumorous diseases, bladder stones, or urethral strictures are also common causes.

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Written by Li Liu Sheng
Nephrology
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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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Written by Zhou Qi
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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.