Hydronephrosis: Causes, Symptoms, Treatment and Cost

Hydronephrosis is a condition in which one or both kidneys swell owing to urine buildup.

It happens when the urinary system becomes obstructed and urine cannot flow properly from the kidney.

It is divided into the following categories based on a variety of variables, including:

• Ureteropelvic junction (UPJ) obstruction: This is the most frequent cause of hydronephrosis, and it happens when the ureter (the tube that takes urine from the kidney to the bladder) becomes obstructed at its attachment to the renal pelvis. Symptoms of this condition include water retention in the kidneys and a swollen abdomen (the area where urine enters the kidney).
• Ureterovesical junction (UVJ) obstruction: When the ureter comes into touch with the bladder, a blockage stops urine from flowing out of the bladder, causing it to back up into one or both kidneys.
• Vesicoureteral reflux (VUR): This condition occurs when urine flows back up into one or both kidneys due to an abnormally functioning valve between them and the bladder.
• Congenital abnormalities: Some people are born with certain defects that can lead to hydronephrosis, such as an abnormally shaped urinary tract or problems with nerve signalling in certain areas of it.
• Kidney stones: The presence of stones in either one or both kidneys can cause blockages that result in hydronephrosis.

The most common cause of hydronephrosis is:

• Obstruction in the urinary tract
• Kidney stone
• Tumour
• Enlarged prostate
• Blockage of the ureters (the tubes connecting the kidneys to the bladder)
• A faulty link between the ureter and the bladder.

Common hydronephrosis symptoms include:

• Pain in the side or back
• Pain during urination
• Frequent urination
• Urinary tract infections (UTIs)
• Nausea and vomiting
• Fever and chills

Swelling of the abdomen, legs, or feet if there is a large amount of urine accumulation in the kidney.

To prevent hydronephrosis:

• It is important to drink plenty of water throughout the day
• Limit alcohol and caffeine intake
• Regularly performing self-examinations for any signs of kidney issues can also help in prevention efforts.

There are several laboratory tests that can be used to diagnose hydronephrosis. Some common tests include:

• Urinalysis: This test looks for evidence of infection or other abnormalities in a urine sample.
• Kidney function tests: These tests analyse the function of the kidneys by measuring the amounts of particular chemicals in the blood, such as creatinine and blood urea nitrogen.
• Ultrasound: An ultrasound produces pictures of the kidneys and urinary system by using sound waves as the imaging medium.
• CT scan: A CT scan produces comprehensive pictures of the kidneys and urinary system by using x-rays as the imaging modality. This can be helpful in determining the degree of hydronephrosis as well as confirming the diagnosis.
• MRI: Imaging of the kidneys and urinary system may be produced by an MRI with the use of magnetic fields and radio waves. An MRI, much like a CT scan, can be helpful in confirming a diagnosis of hydronephrosis and determining the severity of the condition.

Possible complications of hydronephrosis may include :

• Infection
• Scarring
• Damage to the kidney tissue
• In severe cases, the condition can cause kidney failure.
• Other related problems include
• High blood pressure
• Pain in the side or abdomen
• Urinary tract infections.

• Drink lots of water: Drinking plenty of water is essential for flushing out toxins and reducing the risk of kidney infections. This can help prevent and treat Hydronephrosis.
• Herbal teas: Herbal teas such as nettle tea, dandelion tea, and green tea can help reduce inflammation and flush out toxins from your body.
• Dried fruits: Dried fruits such as apricots, dates, figs, prunes, and raisins are rich in antioxidants which can help reduce inflammation in the kidneys and reduce the risk of Hydronephrosis.
• Parsley juice: Parsley juice is a great home remedy for Hydronephrosis due to its anti-inflammatory properties. It helps flush out toxins from the kidneys while helping to protect them from further damage.
• Turmeric: Turmeric has powerful anti-inflammatory properties that can help reduce inflammation in your kidneys caused by Hydronephrosis or other kidney disorders.
• Aloe vera juice: Aloe vera juice helps improve kidney function by reducing inflammation and flushing out toxins from your body that may have accumulated due to Hydronephrosis or other kidney diseases

In general, it is recommended that people with hydronephrosis follow a healthy diet that is low in saturated fat, cholesterol, and sodium.

Foods that are recommended include :

• Lean proteins (like fish and poultry)
• Grains
• Fruits and vegetables
• Low-fat dairy products
• Healthy fats (such as olive oil)

It is important to avoid certain foods and beverages when living with Hydronephrosis. These include

• Foods that are heavy in salt, goods that have been processed, and fried foods all contribute to an unhealthy lifestyle.
• Organ meat, dairy items with a high fat content
• Liquids containing caffeine, such as coffee and tea, as well as alcoholic beverages
• Beverages with carbonation and sugary snacks

Treatment for hydronephrosis depends on the underlying cause and severity of the condition. Some of them includes

• Pyeloplasty: A reconstructive ureterectomy is a surgical technique that realigns the ureter so that urine may flow properly from the kidney.
• Endoscopic Ureteral Reimplantation: Urological surgery including the reattachment of the ureter to the bladder after it has been repositioned.
• Nephrectomy: An operation to remove all or part of a diseased kidney. This can be done laparoscopically (minimally invasive) or by open surgery.
• Ureteral Stent Placement: A thin tube that is inserted in the ureter to allow urine to flow more freely from the kidney and into the bladder.
• Percutaneous Nephrostomy: A medical treatment in which a tiny tube is inserted through an incision in the skin and directly into a clogged urinary system. This allows urine to drain directly from the kidney into a drainage bag that is located outside of your body.
• Ureteral reimplantation: This procedure involves re-attaching the ureter to a different area in the bladder in order to redirect urine flow.
• Ureteral stent placement: This procedure involves placing a small tube inside the ureter to keep it open and allow urine to pass through more easily.
• Pyeloplasty: This procedure involves removing any blockage that is causing obstruction, such as an enlarged prostate or stone, and reconstructing the ureters and renal pelvis.
• Nephrectomy: In some cases, a complete removal of the kidney (nephrectomy) may be necessary if there is severe damage or infection present that cannot be treated with other methods.

To diagnose and treat this condition, it is important to consult a urologist, who specialises in diseases and conditions of the urinary tract.

• Pain medications: Medications known as nonsteroidal anti-inflammatory medicines (NSAIDs), which include ibuprofen and naproxen, have been shown to be effective in reducing the discomfort and edoema caused by hydronephrosis.
• Antibiotics: Antibiotics may be prescribed to treat any underlying infection that is causing the hydronephrosis. Examples include penicillin.
• Diuretics: Diuretics are medications that encourage urine and, as a result, assist lower the quantity of fluid that is stored in the body. This may assist alleviate some of the pressure that has been placed on the kidney as a result of the accumulation of fluid that is produced by hydronephrosis. Example contains Bumetanide (Bumex) Ethacrynic acid (Edecrin) Furosemide,Torsemide.

The amount of time it takes to recover from Hydronephrosis will depend on the severity of the condition, as well as any underlying causes.

• Generally speaking, milder cases may take a few weeks to resolve with medical treatment.
• More serious cases can take several months to heal or may require surgery to correct the underlying cause.
• In all cases, following your doctor's advice is key for achieving the best recovery outcome.

• The results of treatment for hydronephrosis depend on the underlying cause, but in many cases they can lead to a permanent improvement in symptoms.
• With prompt and appropriate treatment, most people with hydronephrosis can expect a good outcome and long-term relief from their symptoms.

Post treatment guidelines for hydronephrosis vary depending on the severity of the condition and the underlying cause, but may include:

• Avoiding activities that put stress on the affected kidney, such as heavy lifting or contact sports.
• Monitoring fluid intake to ensure proper hydration levels.
• Performing regular urine tests and ultrasounds to check for any further changes in the size of the affected kidney or any other complications from surgery or disease.
• Keeping follow-up appointments with a specialist to monitor progress and detect any further complications from surgery or disease.
• Following lifestyle modifications recommended by a doctor, such as reducing salt intake, maintaining an appropriate weight, avoiding smoking and limiting alcohol consumption (if necessary).

Generally, the cost of treating Hydronephrosis can range from 10000 rupees to one lakh, depending on the severity and complexity of the condition. Factors that affect the cost of treatment include hospital charges, doctor consultation fees, diagnostic tests and imaging procedures.

Common side effects include

• Nausea
• Vomiting
• Diarrhoea
• Abdominal pain
• Dizziness
• Fatigue

In some cases, the patient may experience an allergic reaction to the medication prescribed or other complications related to surgery.

If you are suffering from any complications relating to Hydronephrosis then you should consult a doctor nearby as they can cause complications like 'urinary tract infections, difficulty passing urine, kidney failure 'in which treatment course can range from a few months to years depending on the severity of the situation.