How is hydronephrosis diagnosed?

Written by Zhou Qi
Nephrology
Updated on January 09, 2025
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Strictly speaking, hydronephrosis cannot be considered an independent disease; it is merely a descriptive term in imaging, and is the result of many causes and various etiologies. It occurs because urine produced by the kidneys cannot smoothly pass through the ureters and bladder to be excreted from the body, leading to fluid accumulation in the renal pelvis and calyces. This may be caused by prostate enlargement, tumors in the urinary system, urinary system stones, or chronic inflammation and scarring of the ureters. Generally, hydronephrosis can be detected through imaging techniques, including urinary system ultrasound or CT, which can confirm the diagnosis.

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How to relieve nausea caused by hydronephrosis?

Hydronephrosis with nausea can be caused by various reasons, so alleviating nausea symptoms requires specific analysis based on the specific cause. Patients with hydronephrosis often seen in hospital beds are mostly those with ureteral stones. When the stone is lodged in the ureter, the patient will experience an obstruction of urine outflow, leading to hydronephrosis. Moreover, a stone stuck in the ureter can cause renal colic, manifested as back pain, and may also be accompanied by symptoms of nausea and vomiting. In such cases, treatment methods depend on the size of the stone; if the stone is relatively small, it can often be passed naturally with increased water intake and conservative treatment. If the stone is large, it generally requires surgical removal. Hydronephrosis can also result from prolonged obstruction leading to impaired kidney function and uremia. In these situations, it's usually necessary to promptly relieve the urinary obstruction, maintain urethral patency, and, if the patient has elevated blood creatinine levels, employ dialysis or other methods to bring creatinine back to reasonable levels.

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What should I do if I have hydronephrosis and atrophy?

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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Nephrology
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Does hydronephrosis hurt a lot?

Hydronephrosis does not necessarily cause severe pain. If the hydronephrosis develops suddenly over a short period, it might cause intense pain, most commonly due to urinary system stones blocking the ureter, leading to hydronephrosis. At this time, the ureter may experience spasms, causing severe pain. However, if the hydronephrosis develops gradually, the patient's pain symptoms might not be pronounced. For example, insufficient motility of the ureter or some type of narrowing could lead to the accumulation of fluid. If this condition develops slowly and persists for a long time, the patient might not feel particularly uncomfortable, despite the hydronephrosis, and it may only be discovered incidentally during a physical examination.

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Nephrology
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How is hydronephrosis caused?

The causes of hydronephrosis can be divided into congenital, acquired, and external factors. Among these, acquired causes are the most common, primarily referring to obstructions in the urinary tract, such as stones that block the ureter, leading to hydronephrosis, inflammation, or ischemic damage. Scarring of the ureter can also result in hydronephrosis. Tumors or polyps in the renal pelvis and ureter may also cause obstructions leading to fluid accumulation. External causes mainly include diseases of retroperitoneal organs, such as abscesses, bleeding, tumors in the retroperitoneum, and pelvic tumors, like rectal cancer. Congenital causes mainly involve intrinsic narrowing of the ureter, ectopic vessels causing compression, and high insertion of the ureter, which are less common.

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Kidney hydronephrosis atrophy symptoms

Severe hydronephrosis may cause kidney atrophy. The symptoms of the patient can be divided into two aspects: Firstly, hydronephrosis may cause some clinical symptoms, such as some patients may experience swelling in the lumbar and back area, and a decrease in urine output. Patients may suffer from spasms of the ureter due to obstruction of the urinary system, resulting in severe pain, and some patients may also have hematuria. On the other hand, the atrophy of kidney tissue caused by this hydronephrosis actually means the loss of kidney function. Patients may exhibit symptoms of renal failure, such as swelling of limbs, increased blood pressure, nausea, vomiting, loss of appetite, anemia, and other clinical symptoms.