Kidney Swelling (Hydronephrosis): Let's learn about the causes, symptoms, and treatment in a simple way!

Have you ever felt nauseous with severe pain in your back or abdomen? Or have you felt strange or painful when urinating? These can sometimes be a problem with your kidneys. Today we are going to talk about a condition related to the kidneys that many people are not aware of. This is called Hydronephrosis.

What exactly is hydronephrosis?

Simply put, this is when something blocks the flow of urine from your kidneys to your bladder. Think of it like a water pipe getting stuck in the middle. What happens then? The urine can't get out and collects inside the kidney, causing the kidney to swell. This swelling of the kidney is called Hydronephrosis.

This can happen suddenly, or it can happen gradually over time. Sometimes the urethra is completely blocked, sometimes it is less blocked.

• If only one kidney is affected: it is called `unilateral hydronephrosis`.
• If both kidneys are affected: It is called `bilateral hydronephrosis`.

This can range from mild to severe swelling. Early treatment can reduce the risk of long-term damage, so it's important to be aware of this.

To understand this, let's first look at how our urinary system works.

The main function of our body's urinary system is to remove waste and excess fluid. There are a few main parts of this system:

• Kidneys: These are the two main filters in our body. The kidneys filter out toxins and waste products from the blood and produce urine.
• Two ureters: These are the two tubes that carry urine, produced in the kidneys, to the bladder.
• Bladder: This is the sac that collects urine.
• Urethra: Urine that collects in the bladder exits the body through this tube.

Hydronephrosis often occurs when there is an obstruction somewhere between the kidney and the ureter.

How do you know if you have hydronephrosis? What are the symptoms?

Often, the symptoms depend on the cause. Some people may not have any symptoms at all. Especially in babies who have hydronephrosis in the womb, symptoms may not appear until after birth.

However, if symptoms do appear, they may look like this.

Why does Hydronephrosis occur? What are the main causes?

The main reason for this is an obstruction or blockage somewhere in the urinary system. This blockage can be caused by various things.

Common causes affecting adults

• Kidney stones: The most common cause is stones that become lodged in the kidneys or urinary tract.
• Tumors: A cancerous or benign tumor in the bladder, prostate gland, uterus, or other organ close to the urinary system can cause a blockage in the passage of urine.
• Benign Prostatic Hyperplasia (BPH): As men age, the prostate gland can enlarge, causing pressure on the urethra and obstructing urination.
• Narrowing of the urethra: The urethra can become narrow due to scarring after an accident, infection, birth defect, or surgery.
• Nerve or muscle problems: Nerve disorders that affect the function of the kidneys or urinary tract.
• Vesicoureteral Reflux: The backward flow of urine from the bladder through the ureters to the kidneys.
• Ureterocele: A condition in which the lower end of the urethra protrudes into the bladder.

Reasons specific to women

• Pregnancy: As the uterus enlarges during pregnancy, it can put pressure on the ureters and obstruct the flow of urine.
• Uterine prolapse: The uterus descends from its normal position.
• Cystocele: A condition in which the wall between the bladder and vagina weakens, causing the bladder to protrude into the vagina.

How does the doctor find out if this condition exists?

Since hydronephrosis can cause long-term kidney damage, it is very important to see a doctor as soon as possible to get a diagnosis.

Your doctor will use these tests to diagnose this condition:

• Physical exam: Your doctor will ask you about your symptoms and will examine your kidneys and bladder area for swelling or pain. They will also ask about your and your family's medical history. If you are a man, they may do a rectal exam to check for an enlarged prostate gland, and if you are a woman, they may do a vaginal exam to check for problems with your uterus or ovaries.
• Urine tests: A urine sample is taken and checked for blood, stone fragments, bacteria, or infection.
• Blood tests: A complete blood count (CBC) may be done to check for infection. Tests such as creatinine, eGFR, and BUN may also be done to check kidney function.
• Imaging tests: An ultrasound scan is usually performed. Sometimes a CT scan or MRI scan may be needed to obtain further information.

Okay, now let's talk about treatment.

The main goal of treatment is to relieve the obstruction to urine flow and reduce swelling and pressure on the kidney. The treatment method depends on the underlying cause of the condition.

Some mild cases may resolve on their own without any treatment. In such cases, your doctor may recommend a "wait and see" approach.

• Urinary drainage: In cases of sudden, severe obstruction, a tube (nephrostomy tube) can be inserted through the skin into the kidney to drain the accumulated urine. Another option is to place a thin plastic tube called a ``ureteral stent`` inside the urethra to create a path for urine to flow.

If it's because of kidney stones...

• Shock wave lithotripsy: High-energy shock waves are sent from outside the body to break up kidney stones and force them out through the urine.
• Ureteroscopy: A device with a thin camera is passed down the urethra to break up or completely remove stones.
• Surgery: If you have very large, difficult-to-remove stones, surgery may be necessary to remove them. Surgery may also be necessary to remove obstructions caused by lumps or scars.

Can this be serious? How can I prevent it?

Yes, Hydronephrosis can be serious if not treated quickly. In severe cases, it can damage the kidneys and lead to kidney failure. In that case, dialysis or a kidney transplant may be necessary.

But, don't worry! Most people recover completely after prompt treatment. There is no permanent damage to the kidneys.

This is because of another underlying medical condition, so to prevent Hydronephrosis, it is important to treat the underlying condition as soon as possible. If you are a person who develops kidney stones, it is important to make the necessary lifestyle changes.

You definitely need to see a doctor!

If you have the following symptoms, don't ignore them. See your doctor as soon as possible.

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