Generally, hydronephrosis does not contribute to long-term problems as long as it is treated and diagnosed early on. In some cases, hydronephrosis can increase a person’s risk of developing urinary tract infections and, if left untreated, can cause scarring of the kidney, which could ultimately lead to kidney failure.
Hydronephrosis causes
Hydronephrosis occurs due to blockage of the outflow of urine from the kidney to the bladder leading to kidney distension. The condition can be caused by a kidney stone (most common cause), blood clot, prostate enlargement, fecal impaction, injury, infection, radiation, or even a tumor. Pregnant women may also develop hydronephrosis as an enlarging uterus can create pressure, leading to the blockage of urinary output.
To better classify the causes of hydronephrosis, the location of the swelling can either be referred to as intrinsic (located within the urinary collecting system), extrinsic (located outside urinary collecting system, or due to an alteration of urinary function. The following are the causes of hydronephrosis according to this classification:
Intrinsic:
- Ureter
- Kidney stones
- Blood clot
- Stricture or scarring
- Bladder
- Bladder cancer
- Bladder stones
- Cystocele
- Bladder neck contracture
- Urethra
- Urethral stricture
- Urethral cancer
- Urethral valves
Extrinsic:
- Ureter
- Retroperitoneal fibrosis
- Ovarian vein syndrome
- Cancer of the cervix
- Cancer of the prostate
- Pregnancy
- Uterine prolapse
- Scarring due to radiation therapy
- Tumors and cancers
- Urethra
- Prostate hypertrophy
- Prostate cancer
Functional causes
- Bladder
- Neurogenetic bladder
- Vesicoureteral reflux
Complications of swollen kidney
If left untreated, hydronephrosis can lead to increased pressure within the kidney that will inhibit its ability to perform its function, causing poor removal of waste products from the blood as well as unregulated electrolyte balance in the body. The possibility of infection also increases exponentially, which in some cases can lead to loss of function or even kidney failure.
Upon the onset of hydronephrosis, kidney function will almost certainly decrease, however, it is reversible if the resulting swelling resolves. Typically, the kidneys are able to recover well even if obstruction lasts for up to six weeks.
The kidneys enlarge due to excessive pressure upon the urinary system, caused by some sort of obstruction. Because of this, urine will engorge the affected kidney(s), causing tissue damage and loss of kidney function over time. The length of time the obstruction remains will directly affect the type of symptoms experienced.
Mild symptoms include:
- Increased urinary frequency
- Increased urge to urinate
Severe symptoms include:
- Pain in the abdomen or flank
- Nausea
- Vomiting
- Pain during urination
- Incomplete voiding
- Fever
Chronic cases of urinary obstruction also increase the incidence of urinary tract infection (UTI), which can present with the following symptoms:
- Cloudy urine
- Painful urination
- Burning with urination
- Weak urine stream
- Back pain
- Bladder pain
- Fever
- Chills
Diagnosing swollen kidney
Diagnosis will involve taking a detailed history and physical, making note of any abnormal or distressing symptoms and reviewing past medical history. The flank area will also be assessed, looking for signs of pain and tenderness. Males may also benefit from a prostate exam. Conversely, women may benefit from a pelvic exam.
Laboratory tests:
- Urinalysis
- Looking for presence of blood, infection, and abnormal cells within the urine
- Blood test
- Looking electrolyte concentrations
- BUN (blood urea nitrogen), creatinine and glomerular filtration rate (GFR)
Imaging Studies:
- Ultrasound
- Used to evaluate the structures in the abdomen and retroperitoneum
- CT scan
- A more detailed imaging test that allows for the better assessment kidney anatomy. This may be a useful test to look for kidney stones or strictures that are causing compression of the urinary collecting system. CT scans may be enhanced with the aid of contract dye helping to better outline internal structures.
Hydronephrosis treatment
Hydronephrosis treatment in adults first includes draining of the urine, which is built up in the kidneys. A catheter is inserted into the bladder and kidneys in order to relieve added pressure.
Only until the excess urine has been expelled can treatment of the underlying cause begin. Some examples of treatment options for hydronephrosis include:
- Removing kidney stones
- Treating an enlarged prostate with surgery or medications
- Surgically adding stents to reduce narrowing of the ureters
- Treating cancer
Your doctor will be able to choose the appropriate form of treatment based on your needs and the underlying cause of your swollen kidneys.
Home remedies for swollen kidneys
Renal diet: Adhering to a kidney conscious diet can help ensure sufficient energy is produced and the prevention of bodily tissue breakdown. Components of such a diet include:
- Healthy carbohydrates – fruits, vegetables, grains
- Canola oil and olive oil – help provide healthy fats, helping to protect the arteries
- Low-protein diets – depending on the recommendations by your doctor and if you currently require dialysis. Healthy fats, fish, eggs, pork, and poultry.
Foods to avoid: Patients with kidney problems often require limitations on the amount of fluids obtained and of particular foods that may lead to problems if eaten in excess. In particular, high phosphorous containing foods, such as proteins, can lead to a condition called hyperphosphatemia. It is recommended for patients with kidney problems to limit dietary phosphorus to 1,000mg per day.
The following are some home remedies for hydronephrosis that may be useful for treating the condition. However, it is advised to speak to your doctor before beginning any alternative types of therapy for kidney problems.
- Kidney tonic: Take two teaspoons of olive oil and lemon juice and mix them well. You may consume the mixture as is or mix with a glass of water.
- Watermelon: A good option for those suffering from kidney stones.
- Pomegranate seeds: Grinding them up into a paste and having a cup of horse gram soup can help dissolve kidney stones.
- Radish leaf juice: Can promote kidney health if consumed twice a day.
- Herbal remedies: Phyllanthus niruri, horse tail, and Boerhaavia diffusa can be helpful in treating kidney stones as theu act similar to diuretic medication.