How to understand that the baby has a dilated kidney and how to treat
May 12, 2018
Situations when a child has a dilated kidney is not rare. In another way, this pathology in medicine is called pyeloectasia. It can be congenital, when the newborn has dilated the kidney of the kidney, or acquired, affects either of the two kidneys and, in rare cases, just two.
Basically, this disease is detected in boys, and the risk of developing it in girls is three to five times lower. In connection with the fact that the kidneys are a pair body, the doctors classify a one-sided and two-sided increase in the pelvis.
If the expansion of the pelvis is accompanied by the expansion of the calyx, this may also indicate a transformation of the kidneys. Also, simultaneously with the pelvis, the size of the ureter may increase.
Causes of the development of
The development of pyeloectasia is promoted by hereditary predisposition or harmful toxic effects on the mother and child during pregnancy.
In general, the disease occurs due to a violation of urinary diversion.
With vesicoureteral reflux, urine from the bladder penetrates back into the pelvis, therefore the reverse urinary flow is assumed to be the prerequisite for the expansion of the pelvis. With the normal functioning of the organs, the main obstruction of reflux is the valve located at the point of entry into the bladder of the ureter. If the valve stops working properly, the urine rises back to the pelvis, provoking an increase in its size.
Another reason for the increase in the renal pelvis in a child is an increase in the pressure in the bladder, which is developing due to a malfunction of the nervous supply in the bladder.
Stages of development and manifestations of the disease
The process, when a child or a newborn has an enlarged kidney, can be divided into three stages:
- Enlarged renal pelvis, not accompanied by a disturbance of kidney function.
- Enlargement of the renal pelvis and calyx, accompanied by partial disruption of the kidneys.
- Enlargement of the renal pelvis, accompanied by symptoms of tissue thinning and impaired renal function.
In most cases, doctors can detect the expansion of the renal pelvis as early as the 16th-17th week of childbearing, so this pathology is increasingly referred to as congenital.
The norm in newborns can not exceed 7 - 10 mm. The process of enlarging the pelvis does not provoke pain or other unpleasant sensations, because it is asymptomatic. If an ultrasonic examination revealed an enlargement of the pelvis, the doctor prescribes an additional X-ray of the bladder and kidneys.
The risk of developing an increase in renal pelvis is the increased risk of developing other abnormalities that cause impairment of urine outflow. Basically, pyeloectasia is accompanied by the following complications:
- Hydronephrosis is a pathology provoked by the formation of an obstruction in the transition zone from the pelvis to the ureter and manifested by a sharp increase in the size of the pelvis without increasing the size of the ureter.
- Pyelonephritis - the development of the inflammatory process in the kidney.
- Bladder ureter reflux is the process of backflow of urine into the kidney from the bladder.
- Megaureter - a sharp increase in the ureter caused by ureteral reflux, a narrowing of the ureter in the lower part and high rates of pressure in the bladder.
- Valves in the posterior urethra of boys.
- Ectopic ureters - the ureter enters the urethra in boys and in the vagina of girls. Often this complication develops when the kidney is doubled.
- Ureterocele - the ureter bloated in the form of a vesicle at the point of confluence into the bladder. And its outlet is narrowed.
Light varieties of the process of pyeloectasia mainly pass without medical intervention, and severe manifestations require the organization of treatment and in some situations - surgical intervention.
If the kidney of the kidney is enlarged in the child, ultrasound examination of the urinary tract and kidneys is required already in the first months of life. When diagnosing an expansion of pelvis, it is required to constantly monitor their size and urine tests.
If the pathology has a mild course, then doctors conduct regular ultrasound examinations every three months. If a urinary infection is detected or the degree of pyelonectasia is increased, the child is referred for urological examination by means of radiological methods. Thanks to these methods, the specialist receives a full picture of the disease, establishes the level of its development, the form, the causes of the violation of urinary diversion and develops suitable treatment. It is important to understand that the expansion of the renal pelvis in a child is not a terrible disease for life. This disease is well curable.
Children with a diagnosis of pyelonectasia are treated according to the established form of the disease and the cause of its occurrence. If the increase in the renal pelvis is not strong, it affects one or both of the kidneys - then this is an easy or medium stage of pathology. In this situation, the child should be under the supervision of a nephrologist, constantly undergo an ultrasound examination of the kidneys and take urine tests. In the absence of obvious deterioration in the state of health and visible manifestations of the disease, the doctor appoints the patient to take a course of physiotherapeutic procedures, use herbal medicines and control ultrasound. Thanks to the described therapy in most children, the lung and middle forms of pelvic enlargement are spontaneous.
It is important to understand that it will not be possible to cure this disease with a universal method or only with a medicine. Also, it is not possible to predict the development of pyeloectasia after the child's birth.
In some cases - with a strong increase in the renal pelvis or with an irregular structure of the ureter - it is impossible to do without an operative intervention, which involves removing the existing obstruction for urinary diversion. In this situation, experts do not recommend waiting for the moment when the problem is eliminated, as this can lead to a complete loss of the kidney.
If pyeloectasia takes a heavy course, and the size of the renal pelvis continues to increase, surgical intervention in the disease process is also required, which will make it possible to remove the obstruction or get rid of vesicoureteral reflux. Modern technologies in medicine make it possible to dispense with surgery in the literal sense of the word, because surgical interventions are being organized by means of endoscopic methods, using small instruments inserted through the canal.
The basic rules of treatment are to prevent the process of the disease from running out, to undergo regular investigations with a nephrologist, and ultrasound examinations.