What Are the Different Types of Hydronephrosis Treatment?

Hydronephrosis refers to the enlargement of the renal pelvis and renal pelvis accompanied by atrophy of the renal tissue due to urinary tract obstruction. Urinary tract obstruction can occur anywhere in the urinary tract and can be unilateral or bilateral. The degree of obstruction can be complete or incomplete, and can cause hydronephrosis after a certain period of time. When hydronephrosis volume exceeds 1000ml, or when children exceed their 24-hour urine output, it is called giant hydronephrosis. Hydronephrosis is mostly caused by obstructive diseases of the upper urinary tract. Common causes are congenital narrowing of the pelvic ureteral junction and ureteral stones. Long-term lower urinary tract obstructive diseases can also cause hydronephrosis, such as benign prostatic hyperplasia and neurons Sexual bladder dysfunction and so on. The degree of standing water is divided into light, medium and heavy. In mild cases, the renal pelvis is only dilated. In moderate cases, the renal pelvis also expands. In severe cases, the renal pelvis becomes fused, and the kidney becomes a sac.

Hydronephrosis

Overview of hydronephrosis

Hydronephrosis refers to the enlargement of the renal pelvis and renal pelvis accompanied by atrophy of the renal tissue due to urinary tract obstruction. Urinary tract obstruction can occur anywhere in the urinary tract and can be unilateral or bilateral. The degree of obstruction can be complete or incomplete, and can cause hydronephrosis after a certain period of time. When hydronephrosis volume exceeds 1000ml, or when children exceed their 24-hour urine output, it is called giant hydronephrosis. Hydronephrosis is mostly caused by obstructive diseases of the upper urinary tract. Common causes are congenital narrowing of the pelvic ureteral junction and ureteral stones. Long-term obstructive diseases of the lower urinary tract can also cause hydronephrosis, such as benign prostatic hyperplasia and nerve source. Sexual bladder dysfunction and so on. The degree of standing water is divided into light, medium and heavy. In mild cases, the renal pelvis is only dilated. In moderate cases, the renal pelvis also expands. In severe cases, the renal pelvis becomes fused, and the kidney becomes a sac.

Causes of hydronephrosis

Urinary tract obstruction can occur suddenly or gradually. The common causes of urinary tract obstruction are as follows.

Hydronephrosis

Congenital malformations such as ureter or posterior urethral valve and urethral stricture; Foreign bodies such as urinary stones, blood clots, necrosis of kidney papillae, etc .; Tumors such as renal pelvis, renal calyx, ureter and bladder tumor; Inflammation such as ureteritis and Urethritis and so on.

Extrapelvic compression of hydronephrosis

tumors of the bladder and ureteral adjacent tissues, such as prostate cancer, uterine and cervical cancer, retroperitoneal tumors, etc .; benign prostatic hypertrophy; inflammation of the tissue around the urinary tract and retroperitoneal fibrosis; renal ptosis with ureteral distortion; pregnancy uterus.

Hydronephrotic dysfunction neurological dysfunction

Such as spinal cord injury causes bladder paralysis, and other dysfunctional obstructions such as ureter, bladder and urethra.

Pathological changes of hydronephrosis

Even after the urinary tract is completely blocked, glomerular filtration continues for a certain period of time. However, because the glomerular filtrate cannot be discharged, it diffuses to the renal interstitial and surrounding tissues and finally enters the lymphatic vessels or veins; on the other hand, it accumulates in the renal pelvis and pelvis, which gradually expands the renal pelvis and pelvis, and increases the pressure in the renal pelvis. Kidney tissue and blood vessels in it reduce blood flow, and kidney tissue gradually shrinks after compression. In the early stage, the renal tubules are mainly involved, and the renal condensing function is reduced. Later, it gradually affects the glomeruli and reduces the glomerular filtration. Complete urinary tract obstruction usually takes about three weeks, and incomplete obstruction can cause serious irreversible damage.

Hydronephrosis can be unilateral or bilateral. Sudden complete obstruction of the urinary tract usually causes a slight enlargement of the renal pelvis and calyces, and sometimes causes renal tissue atrophy. When intermittent incomplete urinary tract obstruction occurs, the renal pelvis and calyces gradually enlarge. Depending on the level of the obstruction, the bladder, ureter, or renal pelvis may expand in succession. Generally, when the obstruction is low, the kidneys are often involved on both sides, and uremic disease can occur when the pelvis and calyces have not expanded to a very serious degree.

To the naked eye, the kidneys increased in varying degrees. In the early stage, only the renal pelvis and renal calamus enlarged, and the renal pyramidal papilla gradually became dull and flat, and then became cup-shaped. In the later stages, kidney tissue atrophies, the cortex becomes thinner, and the cone disappears. The entire kidney can become a thin-walled sac, up to 15-20 cm in diameter. Under the microscope, the renal tubules can be seen to dilate early without significant changes in the glomeruli. The renal tubules gradually shrink and become fibrotic, and the glomeruli gradually shrink and disappear. The kidney tissue is eventually replaced by a thin layer of fibrous tissue.

Clinicopathological relationship of hydronephrosis

Renal swelling and traction of the renal capsule during acute obstruction can cause pain. Early symptoms are related to the cause of hydronephrosis, such as stones blocking the ureter can cause colic; hypertrophy of the prostate can cause urinary dysfunction and urinary retention in the bladder.

In the case of unilateral complete or incomplete obstructive hydronephrosis, due to the normal function of the contralateral kidney, there are often no obvious symptoms and often remain undetected. The lesions often continue to develop, and finally the affected kidney tissue can be completely destroyed. If early detection of urinary tract obstruction can be found in time, renal function may recover.

Bilateral incomplete obstruction, which first affects the renal tubules, is mainly manifested by reduced renal condensing function and polyuria and nocturia. Renal tubular acidosis can occur in some patients. If the bilateral obstruction is not removed, it can lead to oliguria, anuria and uremia.

Clinical manifestations of hydronephrosis

1. Pain in stones, hematuria in tumors, urinary stenosis and difficulty in urination.

2. Swelling waist pain.

3. Complicated infections include chills, fever, and pyuria.

4. Ipsilateral lumbar cystic mass.

5. Chronic renal insufficiency occurs in bilateral obstruction.

Hydronephronic hydronephrosis diet adjustment method

Hydronephrosis light diet

A light diet is one of the principles that patients with hydronephrosis should abide by. Patients can eat foods that contain vitamins and minerals that are beneficial to the human body, such as fruits and vegetables. These substances have a great promotion effect on patients being treated or recovered, and can reduce patient infections, regulate body fluid balance, increase patient immunity, and prevent repeated infections caused by this infection. This is the benefit for patients to eat this kind of food, which will help the patient's recovery. ^[1]

Hydronephrosis protein

In order to meet the needs of patients with hydronephrosis, the patients need to properly take in some nutrients, such as protein, to prevent hypoproteinemia. Therefore, you can choose high-quality protein such as milk, lean meat, eggs and other animal protein to supplement protein in an appropriate amount. However, plant protein has great damage to the kidney, so patients with hydronephrosis should not eat plant protein, such as beans and soy products.

Hydronephrosis low salt diet

For patients with hydronephrosis who have symptoms of edema and hypertension, the intake of salt should be restricted, and foods with high salt content such as preserved foods, industrial salt products, etc. should be reduced. In addition, patients with edema should pay attention to drinking less water to prevent exacerbation of edema.