What should I do if I have hydronephrosis and atrophy?

Written by Zhou Qi
Nephrology
Updated on September 29, 2024
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Hydronephrosis leading to kidney shrinkage indicates that the condition has persisted for a long time. Long-term hydronephrosis places significant pressure on the kidneys, which in turn compresses the kidney tissues causing tissue shrinkage. The destruction and shrinkage of tissues result in the kidneys' inability to function properly, leading to azotemia. Patients will experience chronic kidney failure, a situation that is difficult to reverse. Even if surgery is performed to relieve the obstruction and allow urine to be excreted, the damaged kidney tissue cannot regenerate. Therefore, it is still necessary to relieve the obstruction as soon as possible to avoid further damage to the remaining kidney tissue. For patients who have progressed to uremia, it may be necessary to consider hemodialysis or peritoneal dialysis, or undertake a kidney transplant to sustain life.

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How to relieve pain from hydronephrosis

Hydronephrosis accompanied by pain is generally caused by kidney stones lodged in the ureter leading to renal colic, and the stones in the ureter can cause urinary obstruction, thus presenting as hydronephrosis. To alleviate the pain in such cases, treatment methods are chosen based on the size of the stone. If the kidney stone is relatively small and estimated to be able to pass by itself into the bladder, temporary use of pain relief medication can be administered for symptomatic treatment, along with medication that dilates the ureter to expand its diameter, facilitating the expulsion of the stone. If the stone is large and predicted not to pass on its own, temporary symptomatic treatment with pain relief medication can be used. Meanwhile, after completing preoperative examinations, surgery can be performed to remove the stone, which can also completely alleviate the pain symptoms.

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Nephrology
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What are the symptoms of hydronephrosis?

Patients with hydronephrosis may not exhibit any symptoms. Whether symptoms are present depends on factors such as the extent of renal damage caused by hydronephrosis, the severity of the hydronephrosis, and the duration of hydronephrosis. Some patients might only notice the issue due to a lump in the abdomen or a swelling sensation in the lower back, prompting them to undergo ultrasound imaging that reveals hydronephrosis. Hydronephrosis can cause renal colic, and patients may also experience nausea, vomiting, and reduced urine output. When hydronephrosis is complicated by infection, symptoms like chills, shivering, fever, and headache can occur. Some patients may first present clinically with a urinary tract infection, showing symptoms like fever, frequent urination, urgent urination, and painful urination. In rare cases, hydronephrosis can rupture and lead to bleeding.

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Nephrology
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Is hydronephrosis serious?

Whether the condition of hydronephrosis is serious depends on various factors such as the duration of hydronephrosis, the cause, the extent of fluid accumulation, and more. For example, some patients may have mild hydronephrosis in only one kidney and it may have developed recently; generally, this condition is not very serious. Some patients might have urinary obstructions caused by urinary system stones, and the issue could be resolved using extracorporeal shock wave lithotripsy or surgical stone removal, making the condition not serious. However, in some cases, the cause could be bladder cancer or a tumor near the urinary system compressing the ureter, and if the tumor is difficult to remove, the hydronephrosis might be hard to manage. Long-term fluid accumulation might lead to kidney failure, and these scenarios are considered quite serious.

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Nephrology
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Is hydronephrosis with hematuria serious?

Whether hematuria in patients with hydronephrosis is serious cannot actually be determined by the amount of blood in the urine. It is important to identify the cause and assess kidney function, because hydronephrosis can lead to serious consequences, mainly kidney failure. If the hydronephrosis persists for a long time, it can compress the renal cortex and cause kidney shrinkage, leading to chronic kidney failure. The dangers of hematuria mainly include: first, it may cause significant bleeding, leading to anemia. Second, this type of hematuria could be caused by certain conditions, such as bleeding caused by a tumor in the urinary system, which is quite serious. Whereas bleeding caused by urinary tract infections or urinary system stones, in terms of the nature of the cause, is not considered very serious. However, significant bleeding can also lead to severe anemia and even shock, which would be more serious.

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Nephrology
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Can people with hydronephrosis drink water?

Whether patients with hydronephrosis can drink water depends on whether the hydronephrosis has been resolved. Hydronephrosis occurs due to a blockage in the urinary system, often caused by inflammation, scarring, or adhesions of the ureters, or by obstructions such as stones or tumors in the urinary tract, or possibly by an enlarged prostate, leading to the inability of the bladder to properly expel urine. In summary, when the urine produced by the kidneys cannot be properly expelled from the body, it leads to the expansion of the renal pelvis and calyces, known as hydronephrosis. Drinking water at this time can certainly aggravate the condition of hydronephrosis if the body is already struggling to expel fluids. Therefore, if this blockage remains unresolved, patients should limit their intake of fluids. However, if the obstruction is cleared and the urinary tract is smooth, allowing urine to be expelled normally, drinking water is permissible.