Kidney Swelling – Hydronephrosis

Swelling in the Kidneys is often detected on an Ultrasound. Usually the swelling arises due to blockage in urine flow. Urine starts to collect in the kidney and causes pressure on the kidneys from Inside. The urinary pipe called the ureter may also begin to swell due to the collection of urine from within.

There are grades of this swelling which can indicate the level of the problem and the possible existing renal damage

DegreeImplication
PCS fullnessThis is the mildest form of swelling, but it does denote that the urine is not draining freely form the Kidneys
MildMild Hydronephrosis means that the kidneys are working under pressure and there is ongoing renal damage
ModerateModerate Hydronephrosis indicates that the blockage has been present over some time and damage has taken place permanently to the kindey function. Large part of this damage may still be reversible
SevereSevere Hydronephrosis is a sign of marked renal damage over a long period of time and in some cases the renal function may be completely lost
GrossGross Hydronephrosis is a form of severe hydronephrosis which is used to indicate that the kidney is practically non functioning
Degrees of Hydronephrosis

Causes of Hydronephrosis

As discussed hydronephrosis invariably results from blockage of urine. Here are some common causes of blockage

  • Stone in the kidney or urine pipe called the ureter
  • Narrowing of the ureter called ureteric stricture
  • Narrowing of junction of kidney and urine pipe called Pelvi-Ureteric Junction
  • Reflux of urine back to kidneys due to defective valves (Called Vesico-Ureteric- reflux)
  • Blockage in the Bladder mouth
  • Blockage in the main urine pipe called urethra . See poor Flow

How can Hydronephrosis be treated ?

Hydronephrosis or swelling in the kidneys is treated based on the cause

CauseTreatment
StonesSmall stones may pass with medicines but large ones may need Lithotripsy or Surgical Removal
PUJ Obstruction/ StrictureUsually treated with Laparoscopic Surgery if DTPA Scan suggests damage to kidneys
Blockage in bladder or Urine PipeUsually managed with small endoscopic surgery
Treatment of Hydronephrosis or swelling in the Kidneys

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