Hydronephrosis (swollen kidney): Causes, symptoms, diagnosis, treatment, and home remedies

By: Dr. Victor Marchione | Kidney Health | Sunday, November 26, 2017 - 06:00 AM

hydronephrosisHydronephrosis (swollen kidney) is a result of urine build-up within one or both kidneys, making them swell and enlarged. Anyone can become affected by hydronephrosis even unborn babies as it can be seen during ultrasounds while the mother is pregnant.

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
  • Bladder
  • 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

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.

Hydronephrosis (swollen kidney) causes, symptoms and treatmentHydronephrosis symptoms

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:

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:

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 (swollen kidney) causes, symptoms and treatmentTreatment for hydronephrosis is based on the underlying cause of the condition. Typically, pregnant women and babies do not require 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.
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Related Reading:

Causes of irritable bladder: Symptoms, treatment, and home remedies

Enlarged prostate (BPH) raises chronic kidney disease (CKD) risk in men

Sources:

http://www.nhs.uk/Conditions/Hydronephrosis/Pages/Introduction.aspx

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