Kidney hydronephrosis atrophy symptoms

Written by Zhou Qi
Nephrology
Updated on December 31, 2024
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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.

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Written by Zhou Qi
Nephrology
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What is hydronephrosis?

The so-called hydronephrosis is a morphological description, referring to an obstruction in the urinary system caused by various reasons. After the kidneys produce urine, it cannot be normally delivered to the bladder. This leads to fluid accumulation in the renal pelvis and calyces, which can be detected through imaging as hydronephrosis. The causes of hydronephrosis are numerous. The most common cause is acquired obstruction, primarily due to urinary system stones, scarring from injuries, or tumors in the urinary system compressing the ureter, which often results in urinary tract obstruction. In addition, some congenital causes can also lead to urinary tract obstruction. Examples include segmental dysfunction of the ureter, intrinsic stenosis of the ureter, and twisting of the ureter. However, these congenital obstruction causes are relatively rare.

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Written by Zhou Qi
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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Urology
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Is hydronephrosis prone to recurrence?

Whether hydronephrosis is prone to recurrence depends on the cause of the hydronephrosis. Common causes of hydronephrosis in clinical practice are as follows: First, urinary tract stones. When a stone is lodged in the ureter or urethra, it can cause urinary obstruction. The urine produced by the kidneys cannot be expelled in time, leading to hydronephrosis. If the stones in the urinary system can be completely removed, it generally does not recur easily. However, if there are still quite a few stones in the kidney or bladder after clearing the urinary tract, it is more likely to recur, because the stones might move down, get lodged in the ureter or urethra again, and cause hydronephrosis. Second, prostate enlargement. Hydronephrosis caused by prostate enlargement is generally more likely to recur because the prostate continues to grow in size. Even if the enlarged prostate is surgically removed, it still might lead to urethral stricture, thereby causing hydronephrosis again.

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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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Will hydronephrosis cause facial swelling?

In cases of hydronephrosis, it is not certain whether facial swelling will occur. Since the human body has two kidneys, the kidneys have strong compensatory capabilities. Even if one kidney is completely damaged, if the other kidney remains healthy, the remaining kidney can still perform the function of two kidneys. It can ensure sufficient excretion of water and metabolic waste. When water is sufficiently excreted, swelling should not occur. However, if both kidneys are affected by hydronephrosis, or if the opposite kidney also has problems, then the ability of the kidneys to excrete water may decrease. With both kidneys having issues, it can lead to poor and insufficient water excretion, consequently causing swelling, such as bilateral eyelids, facial areas, and both ankles.