Megakalix( megakalikoz) - Causes, symptoms and treatment. MF.
Jun 25, 2018
Megalics is a congenital pathology of the kidneys, which consists in the diffuse expansion of some calyxes. In the literature there is also a name for this pathology such as megakalikosis.
Causes of megalix
As with any other congenital pathology, it is impossible to name exact reasons for the occurrence of the magakalix. It is precisely explained that the development of this disease is a violation of connective tissue of the kidney. As a result, the renal parenchyma is thinning and the cups are dilated.
For a normal development of the fetal calyx, the woman should avoid any harmful influences during pregnancy. Among the most dangerous factors, it is necessary to isolate teratogenic infections. These include toxoplasmosis, rubella, cytomegalovirus, herpes and others. To prevent infection with these infections, during pregnancy, women almost every month hand over the appropriate tests. It must be remembered that it is infection that is dangerous during pregnancy. If a woman before the fertilization had some antibodies in the blood, this gives a much lower risk of the child developing congenital defects of the genitourinary system.
Multiple studies that are constantly conducted around the world suggest that chemicals and medicines also have a greater impact on the laying of organs and the development of the fetal tissues. It is necessary to remember that it is better for a pregnant woman to minimize contact with such chemicals as varnishes, paints and detergents. Among the drugs, in the first place, it is necessary to note hormonal drugs and anti-tuberculosis drugs, which have a large number of contraindications and, accordingly, side effects.
Symptoms of megacalix
With a slight widening of the calyx of the kidney, clinical symptoms may not be present at all. This is due to the fact that the capsule of the kidney is in an intact state, that is, it does not undergo any influence.
In more complex situations, when the dilated calyx begins to put pressure on the kidney capsule, the patients are concerned about minor pain in the lumbar region. As a rule, they are of a permanent nature, do not extend to other anatomical areas and do not depend on the diet or physical strain of a person.
Because of the thinning of the kidney parenchyma, the juxtaglomerular apparatus suffers, first of all. This affects the amount of renin in the blood plasma, which is progressively increasing. This biological factor, which is a powerful vasopressor agent, increases the tone of the vascular wall, narrowing the arteries. This affects the level of blood pressure, in the first place, diastolic. Patients begin to worry about constant headaches, dizziness, general weakness. In the absence of treatment, one-stage loss of consciousness can be noted.
Diagnosis of megalikix
Various diagnostic methods are used to verify the diagnosis, the conduct of which has different effectiveness. Probably the most common method of diagnosis is to consider ultrasound, in connection with the low cost and effectiveness of the latter. On ultrasound can be noted as an increase in the kidney in general, and individual altered cups. However, with polycystic kidney pathological formations can easily be confused with enlarged cups, so ultrasound can not be considered a reliable diagnostic method.
For final verification of the diagnosis, it is necessary to perform excretory urography, which consists in radiographic examination of the pelvic organs after intravenous contrast. With polycystic kidneys, a normal or reduced pelvis can be visualized, while a large number of enlarged calyxes is noted with a megacalix. The number of altered anatomical formations allows us to judge the stage of pathology.
Excretory urography: megacalix
Often with megacalix, secondary urolithiasis develops. With her on X-ray pictures can be visualized directly by the stones, which, as a rule, are in enlarged cups.
Computed tomography is one of the most accurate, although most expensive, methods of confirming the diagnosis of megacalix.
Computed tomography: megacalix
Treatment of megacalix
In the initial diagnosis of the disease, when there are no clinical signs, observational and waiting tactics are applied to patients. They are recommended to undergo periodic checkups at the urologist, during which it is necessary to perform ultrasound and excretory urography. In principle, the further tactics of treatment directly depends on the dynamics of the disease. If there is a stable dynamics, that is, the pathology does not progress, the patients do not need an operative intervention.
The most frequent indication before surgery for megacalix is secondary urolithiasis. Various surgical procedures can be performed with it. To date, it is often used remote ultrasonic lithotripsy, which consists in crushing stones using a special stationary device. If it is impossible to perform the operation, the indicated method can be used to perform a classical cavitary operation to remove stones.
In addition, surgery for megacalix can also be performed with suppuration of enlarged calyxes. Typically, this happens when there is a secondary infection and the lack of adequate treatment. In such a situation, the purpose of surgical intervention is to open and drain the abscess or to remove the entire organ.
As for conservative treatment, most often, it occurs during secondary pyelonephritis, which develops very well against megacalix. In this situation it is necessary to use antibacterial preparations of a wide spectrum of action, since it is far from always known which flora has caused inflammation of the kidney.
To date, a combination of fluoroquinolones with vancomycin is most often used. The drugs are administered orally for about two weeks. With the resistance of microbes to the prescribed treatment, as a rule, stronger drugs - meropenems are used.
Rehabilitation after illness
When prescribing an active antibacterial treatment, rehabilitation should be directed, first of all, to restore normal intestinal microflora. For this, probiotic preparations can be used for about a week.
Another direction in the rehabilitation of such patients is to consider sanatorium treatment. As a rule, they are recommended to visit mineral resorts, such as Morshin or Sak, where water treatment and prevention of urolithiasis are carried out.
Features of nutrition and lifestyle
Patients with megacalix recommended diet food according to the seventh table for Pevzner. It implies a restriction in the use of spicy, salty, fried, peppery, acidic foods. In addition, it is not recommended to use a large amount of salt and mineral water, which contributes to the development of urolithiasis.
Treatment with folk remedies
Treatment with folk remedies for a similar pathology is simply an incident. Without carrying out additional instrumental methods of diagnosis, it is simply impossible to detect pathology, and this means that any treatment with folk remedies can be considered, if not a fraud, then a little cunning on the part of traditional healers.
Complications of megacalix
As already mentioned, the most frequent complication of this disease is urolithiasis. The cause of its development is a constant stagnation of urine in the cavity of the renal calyces, which gradually leads to the precipitation of salts and the formation of concrements. When this complication occurs, patients begin to complain of increased back pain and spreading them down to the external genitalia. In addition, patients may note some discomfort during urination. As a rule, urine remains transparent, but its slight turbidity is not ruled out.
The next most frequent complication of megalikis is pyelonephritis. Constant stagnation of urine in the kidney is a good substratum for the development of secondary infection. The development of pyelonephritis is manifested by increased pain, deterioration of the general condition, increased body temperature and pallor of the skin. If in this situation to conduct a general urine test, then you can see an increased number of leukocytes and bacteria.
If pyelonephritis is not given active antibacterial treatment, it can develop into suppuration of the renal parenchyma. This clinical condition is called a kidney abscess. He needs immediate surgery, during which the abscess is performed and the cavity is drained.
Prevention of megaliki
It is clear that the prevention of this disease, it is the prerogative of pregnant women. Only it is not always possible to predict the etiological factor, especially since a corresponding mutation can occur suddenly, without any background reasons. Much more important is secondary prevention, which consists in preventing megacalix complications.
First and foremost, secondary prevention is based on proper nutrition and the appropriate water regime. Patients are not allowed to consume a large amount of mineral waters and salty foods, as this leads to an increased release of salts with urine, which is the direct etiologic factor of urolithiasis.
With regard to the prevention of pyelonephritis, it should be based, first of all, on the sanation of chronic foci of infection. Patients need to undergo a thorough investigation to identify chronic sinusitis, tonsillitis, cystitis and cholecystitis. As practice shows, these diseases most often become the causes of the development of secondary pyelonephritis.
Forecast for life - favorable. As practice shows, even the most complex forms of the disease, such as a kidney abscess, do not have lethal outcomes.
The prognosis for recovery is relatively favorable. Only with a kidney transplant can you finally get rid of this pathology.
The prognosis for working capacity is favorable.
Rev.the doctor the urologist, the sexologist-andrologist Plotnikov AN