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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Can you have sex with hydronephrosis?

Before the complete resolution of hydronephrosis, it is recommended that patients avoid sexual intercourse. This is because hydronephrosis indicates the presence of obstructive factors in the urinary system, causing urine to not be excreted smoothly. Urine accumulates within the urinary system, causing dilation of the renal pelvis, calyces, and ureter. If urine cannot be excreted, bacteria can easily ascend from the urethral opening into the urinary system, causing an inflammatory response. If patients engage in sexual intercourse during this time, bacteria at the urethral opening can easily be pressed into the bladder, ascending and potentially causing pyelonephritis or cystitis. Therefore, it is best for such patients to avoid sexual intercourse until the hydronephrosis has been thoroughly addressed.

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Nephrology
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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.

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How is hydronephrosis treated?

The treatment of hydronephrosis often requires surgery. Decisions about diagnosis and treatment plans should be based on clinical symptoms, the duration of the obstruction, the location of the obstruction, and whether there is an infection. Since hydronephrosis is typically caused by a pathological factor that blocks the ureter, surgery is often necessary to remove the obstruction in order to address the hydronephrosis and prevent further damage to kidney function. The principle of the surgery is that if the obstruction is minor, a simple corrective surgery may suffice. However, if the dilation of the ureter and renal pelvis is very significant, a reanastomosis of the ureter and renal pelvis might be needed.

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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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What is the best treatment for hydronephrosis?

The so-called hydronephrosis often occurs due to some factor blocking the urinary system, causing urine to not be excreted normally. The most common cause is urinary system stones, but it can also be due to issues like tumors or benign prostatic hyperplasia. The treatment for stones depends on the size of the stone. Stones smaller than 5 millimeters in diameter can often pass naturally. If the stone is 7 to 15 millimeters in diameter, extracorporeal shock wave lithotripsy is typically used. If stones in the lower mid-ureter do not respond well to medication, retrograde removal under cystoscopy can also be performed. For some patients who have had a long-standing obstruction, renal function may already be impaired. If the obstruction cannot be relieved, surgeries such as creating a urinary diversion can be performed. This includes procedures like bladder fistulation, pyelostomy, or percutaneous ureterostomy, among others.