Hydronephrosis

Hydronephrosis is classified in different ways, depending on its severity, the duration of the condition and whether it affects one or both kidneys. The main types based on categorisation include:

• Based on severity:
  • Mild hydronephrosis: This condition is diagnosed when a slight swelling in the kidney is observed with minimal or no tissue damage.
  • Moderate hydronephrosis: This condition is diagnosed when a greater degree of swelling is observed, which begins to press on the kidney tissue.
  • Severe hydronephrosis: This condition is diagnosed when significant swelling thins the kidney tissue is observed; it may lead to permanent damage if not treated.
• Based on duration:
  • Acute hydronephrosis: This condition is diagnosed when swelling develops suddenly, often due to a kidney stone blocking the flow of urine.
  • Chronic hydronephrosis: This condition is diagnosed when swelling develops gradually, usually because of scarring, tumours, or repeated infections.
• Unilateral or Bilateral hydronephrosis: These conditions are diagnosed when only one kidney or both kidneys are affected, respectively.

As already established the symptoms of hydronephrosis vary depending on the severity and cause of the obstruction. These may include:

• Acute presentation: This is characterised by sudden flank pain caused by a kidney stone blocking the ureter, often accompanied by blood in urine (haematuria). This may be associated with haematuria.
• Infections: They present as fever, abdominal pain, and discomfort..
• Chronic obstruction: This is characterised by persistent renal stones/congenital obstruction of some part of the urinary tract. In many cases it may be completely asymptomatic and be detected incidentally during imaging studies for unrelated reasons.

The obstruction that leads to hydronephrosis can arise from several different causes; these include:

• Kidney stones that block the flow of urine in the ureter.
• Congenital abnormalities, which are structural defects in the urinary tract present from birth.
• Tumours or strictures that narrow or block the passage of urine.
• Pregnancy, wherein the growing uterus presses against the ureters.

Diagnosing hydronephrosis involves:

• Imaging studies such as ultrasound or CT scan of the abdomen to detect swelling and obstruction.
• Urine tests to check for infection or other abnormalities.
• Blood tests such as renal function tests to assess kidney function.

Treatment depends on the underlying cause and severity of hydronephrosis:

• Surgical intervention to remove obstructions such as kidney stones or to correct structural abnormalities.
• IV antibiotics are used to manage associated infections.

Consult your physician immediately if you notice any of the following symptoms:

• Persistent or severe pain in the back, side, or lower abdomen.
• Difficulty passing urine or a marked decrease in urine output.
• Blood in the urine.
• Fever, chills, or burning during urination (possible sign of infection)
• Nausea or vomiting along with urinary symptoms.

Hydronephrosis cannot always be prevented, but some measures can reduce the risk:

• Staying well hydrated to maintain healthy urine flow.
• Seeking prompt treatment for urinary tract infections.
• Having regular check-ups for conditions such as kidney stones or prostate problems can help protect kidney health.

It is advisable to consult a nephrologist or a urologist for proper evaluation and management of hydronephrosis.