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  • Degrees of hydronephrosis: diagnosis and treatment

    As the statistics show, hydronephrosis occurs in about 4.7% of patients who have any malformation of the urinary tract. In boys, this pathology occurs, as is well known, 2 times more often, with hydronephrosis of the left kidney 1 degree or second degree prevailing. About 5% of all cases of disease defeat is complex bilateral.

    Degrees of hydronephrosis: description of stages 1, 2, 3 and 4 of the disease and their symptoms

    Depending on how pronounced the atrophy of the kidney parenchyma, the doctors distinguish four degrees of hydronephrosis:

    1. The first - at this stage of the disease the parenchyma is still preserved.
    2. The second - this stage of the disease is characterized by a minor damage to the parenchyma.
    3. Third - at this stage there is a significant damage to the body.
    4. Fourth - there are no parenchyma, the kidney practically does not function.

    Specialists distinguished several forms / degrees of development of this disease:

    • Hydronephrosis of the kidney 1 degree. This is the early stage of the disease. Urine accumulates directly in the renal pelvis and calyx, fluid pressure builds up in them, and they begin to gradually expand. Since the calyx and the walls of the pelvis are quite elastic, for some time the diseased kidney is still able to somehow cope with suddenly increased pressure.
    • Hydronephrosis of the kidney 2 degrees. Excessively high pressure of the liquid leads to the fact that the calyx and pelvis strongly stretch, while the walls of the kidney tissue become thinner, changing their structure and, accordingly, their performance. At this stage of the disease, about twenty to forty percent of the kidney loses the ability to perform its functions.
    • 3 degrees. This stage of the disease is characterized by the fact that the kidney tissues noticeably atrophy - about sixty to one hundred percent, while the pelvis and calyxes greatly increase in size - almost twice.
    • 4 degrees. This is the last stage of the disease, when the diseased kidney simply ceases to function.

    This is important! The most common hydronephrosis of the left kidney is 2 degrees, with hydronephrosis of the right kidney 2 degrees is not a rare case. In 35-40% of all cases, it develops in the right kidney, and yet the kidney located on the left is more often affected. Bilateral lesion in patients is very rare, as we already mentioned above - in about 5% of cases.

    Clinical picture of the disease

    The severity of hydronephrosis symptoms, as a rule, depends on the stage at which the disease occurs.

    1 degree

    Early clinical manifestations of the disease are most often not expressed, and therefore the ailment is sometimes detected by doctors already in a neglected, complex condition. In general, hydronephrosis of the kidneys of the 1st degree is often characterized by an asymptomatic course.

    But even at the 1st stage of the disease, paroxysmal renal colic is possible, and they are accompanied by:

    • with nausea, vomiting reflexes;
    • bloating;
    • significant increase in pressure( arterial).

    Also for the 1 degree of hydronephrosis is frequent urination, which is usually accompanied by unpleasant sensations, while urine is turbid. Patients often note that their urine output decreases immediately before painful attacks of colic and then increases after these attacks.

    In newborns, hydronephrosis, and indeed in all children, usually does not show itself, as a rule, up to the third degree of the disease. But sometimes in newborns there is an admixture of blood in the urine. Also, an early symptom of the disease( with a disease of 1 degree) is renal colic, in particular it is typical of hydronephrosis, which is caused by urolithiasis.

    2nd degree

    At the second degree of the patient's illness, painful sensations in the lumbar region, which are constantly scarring, regardless of time of day, body position and physical exertion, can be disturbing.

    3 degree

    In the case when the disease reaches the 3rd degree of development, the main symptoms of hydronephrosis are:

    1. Aching stupid and persistent pain in the kidney area.
    2. Symptoms of a decreased renal function:
      • appear edema;
      • observed increased pressure due to water exchange disorders.
    3. Hematuria is one of the common signs of hydronephrosis, which is characterized by the appearance in the urine of blood.

    As a rule, the localization of pains indicates which kidney is affected. If hydronephrosis of the left kidney is observed, the pain is felt on the left, and if the patient has hydronephrosis of the right kidney of the third degree, then, respectively, - on the right.

    4 degree

    For the late stages of the disease, the course of the disease is characterized by a complete absence of acute pain.

    In the event that any infection is attached to the hydronephrosis, there may be a significant increase in temperature during the bouts of pain.

    Degrees of hydronephrosis: diagnosis and treatment of

    The main method for diagnosing this disease is ultrasound examination of the urinary tract and the kidneys themselves. As additional studies, doctors use Doppler color mapping( in other words - CDC), as well as radioisotope renography, and in rare cases, magnetic resonance imaging or computed tomography. Some specialists may prescribe an endoscopic study - urethroscopy or urethrocystoscopy.

    All these techniques are aimed directly at visualizing the entire internal structure of the diseased kidney, as well as the ureters and vessels. And just as hydronephrosis contributes to the onset of infection, urine is digested.

    In newborn children 1 and 2 degrees of hydronephrosis, as practice shows, often goes by their own by the year. At the same time, children diagnosed with "hydronephrosis" are regularly examined with the help of ultrasound - the doctor necessarily controls the course of the disease and the condition of the kidneys. If the disease becomes acute or goes to the third article, it is necessary to proceed immediately to treatment.

    Regarding treatment, it is performed exclusively surgically. Conservative techniques are effective only to eliminate inflammation and alleviate the symptoms of the disease.

    The operation is aimed at removing obstacles that disrupt the normal urinary outflow. Usually doctors give good predictions to their patients and return them to a healthy life.

    But with hydronephrosis, which reached the terminal stage, the kidney, in case of death, is simply removed. Often such operations are carried out by the elderly, when the regenerative functions of their body have already been significantly reduced.

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