From a professional perspective, this kidney condition is defined as follows: Hydronephrosis occurs when urinary tract obstruction impedes the drainage of urine produced by the kidneys, causing it to accumulate within the renal pelvis. Over time, this leads to dilation of the renal pelvis, termed hydronephrosis. Therefore, proactive prevention and treatment are essential—this is the best approach to managing hydronephrosis!
Symptoms of Hydronephrosis
1. Pain
Lumbar pain is the most significant symptom in hydronephrosis patients.In chronic obstruction, symptoms are often subtle, presenting only as dull lumbar discomfort. Most acute obstructions cause significant lumbar pain or classic renal colic. In rare cases, patients may experience acute bilateral or complete obstruction without pain.
2. Renal Enlargement and Abdominal Mass
Chronic hydronephrosis due to obstruction may cause renal enlargement or an abdominal mass. Patients may not necessarily present other symptoms. In cases of long-term obstruction, a cystic mass may be palpable in the abdomen.
3. Hematuria
Hematuria from upper urinary tract obstruction is uncommon. However, if caused by stones or tumors, it may occur alongside renal colic. In cases of partial obstruction with intermittent blockage, increased urine output and hematuria may follow colic episodes.Hematuria or pyuria may also accompany secondary infections.
4. Edema Patients with hydronephrosis often develop facial swelling due to urine accumulation in the kidneys, with eyelid swelling being particularly noticeable.
Preventing Hydronephrosis
Pharmacological Management
While hydronephrosis itself is generally not curable with medication, the following approaches may be used to prevent secondary infections and protect renal function before definitive treatment to relieve urinary obstruction:
1. Traditional Chinese Medicine (TCM): Heat-clearing and toxin-eliminating antibacterial herbs such as Bupleurum, Phellodendron, Scutellaria, and Plantago seed may be used.
2. Antibiotics: Such as Erythromycin, Cefalexin, etc.
Dietary Management
1. For unilateral hydronephrosis, fluid intake need not be restricted. However, in cases of bilateral hydronephrosis with renal dysfunction, daily fluid intake should be limited.
2. Increase caloric intake, but avoid excessive consumption of protein-rich foods to prevent burdening the affected kidneys.Energy should primarily come from carbohydrates and fats.
Treatment Approaches for Hydronephrosis
1. Conservative Management
Typically used for mild, slowly progressing cases where renal function has stabilized. Regular monitoring is essential to track hydronephrosis progression. This approach is suitable for self-resolving obstructions, such as physiological hydronephrosis in pregnant women.
2. Surgical Intervention
Indications for surgery include:Surgical Indications: Surgical intervention is indicated for progressive hydronephrosis with significant clinical symptoms, declining renal function, identifiable obstruction causes, or presence of complications.When hydronephrosis causes extremely poor function in the affected kidney and the contralateral kidney has impaired function due to other diseases, even uremia, nephrostomy should be performed first on the hydronephrotic kidney. Further management of the obstruction can be addressed once renal function recovers. In cases of bilateral hydronephrosis, ensure lower urinary tract obstruction is ruled out.