What is Kidney Enlargement (Hydronephrosis)? How Is It Treated?

Hydronephrosis (accumulation of urine) in the kidney is seen in about one in 100 people. It is also known that in about 2% of all prenatal ultrasound examinations, pregnant women experience some degree of hydronephrosis. Hydronephrosis is recognized as “one of the most commonly detected abnormalities in pregnancy”. {one*}

Having kidney stones , scarring in the urinary system due to past surgeries or infections, frequent urinary tract infections , a history of bladder or colon cancer , or pregnancy may cause kidney enlargement. In addition, anatomical defects can cause hydronephrosis in infants or unborn fetuses.

In most cases, the problem of hydronephrosis goes away with treatment. Kidney enlargement can sometimes correct itself. Severe hydronephrosis always needs to be treated promptly to reduce the risk of potential complications such as permanent kidney damage or kidney failure. Hydronephrosis treatments are performed with antibiotics, pain relievers or surgery. In order to accelerate the recovery of hydronephrosis and support kidney health, it is necessary to follow a healthy diet program, not to be dehydrated, to reduce pain with hot compresses and to prevent kidney stones.

What are the Home Treatment Methods for Kidney Stones?

What is Hydronephrosis?

Hydronephrosis refers to excess fluid that accumulates in the kidney (a collection of urine) due to the inability to expel urine. This condition can affect one kidney or sometimes both kidneys. Unilateral hydronephrosis describes that one kidney is affected, while bilateral hydronephrosis describes that both are affected. It is most common for hydronephrosis to cause dysfunction of one kidney, with the other kidney doing both. This sometimes causes reflux. {2nd*}

The kidneys are small, bean-shaped, fist-sized organs located in the middle of the back under the rib cage. The kidneys are organs connected to the ureter, bladder, urethra, and urinary tract. Their role in the body is to filter waste materials from the blood and to remove excess fluids from the body through urine.

Both adults and children, even infants and unborn fetuses, can develop hydronephrosis if they are not able to properly remove their urine from the body. Hydronephrosis is more common in men than women. Hydronephrosis does not always cause obvious symptoms, which means it can sometimes be ignored or overlooked until it becomes a more significant problem. Pain in the kidneys, tenderness in the back and abdomen, and abnormal urination are some signs that there may be a problem with the kidneys.

What is a Kidney Cyst? What are the Symptoms and Treatments?

What Are the Symptoms of Hydronephrosis?

Symptoms depend on whether hydronephrosis is mild, moderate, or severe. Untreated moderate or severe hydronephrosis can sometimes become very serious and lead to complications, including permanent kidney damage and even kidney failure (though rare). {3*}

The most obvious symptoms of kidney swelling are:

• Pain near the kidneys located against the back muscles in the upper abdomen. Pain felt on the side of the body and back
• pain when urinating
• Urgent or frequent need to urinate
• blood in the urine
• Abdominal or groin pain
• Nausea and vomiting
• Fire
• Growth and swelling in the abdomen
• Urinary tract infection
• Increasing pain in infants

In addition, hydronephrosis can lead to hypertension (high blood pressure), especially in the elderly. Researchers state that this is due to factors such as vasoconstriction (narrowing of blood vessels) and excessive salt and water overload. {4*}

Hydronephrosis differs from nephrosis (or nephrotic syndrome), a type of kidney disease, with edema and protein leakage in the urine. While diabetes is the most common cause of nephrosis in adults , other causes include amyloidosis, multiple myeloma, lymphoma, preeclampsia, systemic lupus, and HIV. Both hydronephrosis and nephrosis can cause the kidneys to swell, but nephrosis is different because it also means too much protein in the urine. This in turn causes symptoms such as malnutrition, muscle loss, and others. Nephrotic syndrome also increases the risk of infection and blood clots. {5*}

What Causes Hydronephrosis?

Hydronephrosis most often occurs because there is a blockage in the tubes (called ureters) that drain urine from the kidneys. The ureters normally take urine from the kidneys and bring it to the bladder so that the urine can be expelled from the body. Sometimes there may be a partial obstruction in the urinary tract where the kidneys and ureter meet, or there may be an obstruction where the ureter meets the bladder. Blockages trap urine in the kidney, causing it to accumulate and stretch. When the ureter is enlarged, it is called a hydroureter.

Vesicoureteral reflux occurs when urine flows back from the ureter and bladder to the kidney. Vesicoureteral reflux is graded according to the degree of reflux: in mild cases, urine only returns to the ureter (grade 1) and is caused by severe kidney swelling (hydronephrosis) and twisting of the ureter (grade 5). {6*}

Hydronephrosis is not a disease in itself, but a side effect caused by other diseases, injuries, infections, or conditions. Some causes of urine accumulation in the kidneys or ureters are: {7*}

• An anatomical defect or congenital obstruction (a defect present at birth)
• scarring of the ureter caused by previous infections, surgeries, or radiation treatments
• Kidney stone
• It can be caused by a tumor in the abdomen or pelvis, which can sometimes be cancerous. For example, hydronephrosis can occur in patients with bladder cancer. It can also be caused by a tumor in the ureter or other ureteral tumors that cause compression of the ureter. {8*}
• prostate enlargement
• Problems with the nerves leading to the bladder
• blood clots
• Inflammation and infection of the kidneys
• In women, congestion from an enlarged uterus during pregnancy
• Uterocele, or the lower part of the ureter that protrudes into the bladder
• Not being circumcised can also cause hydronephrosis. Researchers hypothesize that UTI (urinary tract infection) rates will be lower in boys diagnosed with early hydronephrosis and undergoing neonatal circumcision. A recent study in the journal Pediatrics and published by the American Academy of Pediatrics found that circumcision reduces the risk of UTI in those with isolated hydronephrosis, vesicoureteral reflux, and ureteropelvic junction obstruction. {9*}

Hydronephrosis is not genetic and inherited. But it’s possible for hydronephrosis to occur due to a genetic defect that causes the ureter to become blocked. Hereditary hydronephrosis is recognized as an autosomal dominant trait that causes unilateral or bilateral pelvic-ureteric junction (PUJ) obstruction. {10*}

What Should the Color of Urine Be?

How Is Hydronephrosis Treated?

A doctor or a urologist (who specializes in conditions affecting the urinary system) diagnoses hydronephrosis by performing a physical examination and a series of tests. The doctor may order a blood test, a urine test to check for signs of infection or obstruction, an ultrasound imaging exam to view the kidneys, a cystourethrogram/X-ray exam to observe the kidneys, ureters, bladder, and urethra, and a computed tomography (CT) scan to evaluate how the kidneys are working, magnetic may request a resonance imaging (MRI) or MAG3 scan. Ultrasound can detect structural abnormalities that can lead to hydronephrosis in infants or unborn fetuses. This test is also used to reveal swollen kidneys and primary vesicoureteral reflux (reflux of urine) in an unborn baby.

Sometimes mild hydronephrosis resolves on its own and no treatment is required. But if the condition has become more moderate or severe, treatment is needed to clear any blockages and restore the function of the affected kidney(s). Treatment methods for hydronephrosis include:

• Sometimes only the kidneys are regularly monitored. This is recommended for mild to moderate hydronephrosis, but not recommended if the condition is severe.
• Sometimes antibiotics are also given to help prevent a urinary tract infection (UTI) from spreading or getting worse. Antibiotics prevent the infection from going to the kidneys. This is especially true for people with only one kidney or those with immune system disorders such as diabetes or HIV.
• Analgesics or over-the-counter medications can be used to relieve pain.
• Surgery may be recommended to remove a blockage, but usually this is only needed in severe cases. For vesicoureteral reflux, an operation can also be performed to repair the defect in the valve between the bladder and the ureter and to prevent urine from flowing in the wrong direction. Other surgical options include: open surgery, which is done under general anesthesia and involves an incision in the lower abdomen, robotic-assisted laparoscopic surgery, which uses a smaller incision to repair the valve between the ureter and the bladder, or endoscopic surgery with the aid of a tube (cystoscope) inserted through the urethra and the valve is inserted. A bulking agent is injected to strengthen the closure ability. {11th*}
• If kidney failure occurs, dialysis or a kidney transplant may be required.

Kidney and Bladder Cleaning

What are the Natural Methods to Prevent Hydronephrosis?

There are several home remedies to prevent kidney swelling or reduce its symptoms. Methods that can be used to prevent hydronephrosis include:

Enough Water Should Be Drinked

Consuming plenty of water and fluids helps to dilute the urine and clear bacteria from the urinary system. It is necessary to drink a glass of water every hour while awake, that is, at least eight glasses of water a day. If infants or children have hydronephrosis, they should be given freshly squeezed juice or chilled herbal tea. In addition , it is necessary to avoid fruit juices and soft drinks containing citrus and caffeine .

In Case of Kidney Swelling, Methods to Reduce Pain Should Be Applied

For pain around the abdomen or back, apply a warm compress such as a hot water bottle or a warm, damp towel. It is necessary to apply the towel gently on the abdomen for about 15 minutes several times a day or if necessary. The towel/compress should not be too hot so that it does not burn the skin.

Urinary Continence and Constipation Should Be Avoided

Urine should be urinated every two hours or when necessary, and all urine should be excreted by waiting for a long time. Urine should not be retained as this can make the discomfort worse. Constipation also makes abdominal pain and swelling worse, so here are some things to do to prevent constipation:

• Consume enough high-fiber foods such as a variety of fresh vegetables and fruits , nuts, seeds, soaked legumes/beans, avocados and coconuts
• consuming enough fluids
• staying as active as possible by doing light exercises like walking or stretching
• Getting regular sleep and managing stress properly
• Consuming soaked chia and flax seeds, which form a gel-like consistency that absorbs fluid and helps lubricate stools.

With such methods, it is possible to prevent constipation and reduce the pain of hydronephrosis.

Formation of Kidney Stones Should Be Prevented

Following a healthy diet program that is alkalizing and low in oxalate reduces the likelihood of developing kidney stones. Foods to be eaten to prevent the formation of kidney stones are: {12*}

It is necessary to eat fresh vegetables and fruits. E.g; eat bananas, all kinds of green leafy vegetables (and freshly squeezed vegetable juice), sprouted legumes, sprouted grains, fish, and small amounts of pasture-raised poultry. Foods rich in vitamin E (fruits, olive oil, almonds, avocados and pumpkin) should be eaten. Alkaline foods (lemon juice, apple cider vinegar, raw honey, detox drinks and fresh vegetables) should be consumed. Foods rich in magnesium and potassium (leafy green vegetables, cruciferous vegetables, melons, bananas, cocoa and avocados) should be taken. Sprouted grains (as opposed to refined grain products) make their nutrients more easily digestible, reducing their antinutrient content.

Precautions should be taken to avoid Urinary Tract Infection (UTI)

Things to do to prevent UTIs or keep them from getting worse and spreading include:

Conservation methods should be applied during sexual intercourse. Visit the doctor regularly for annual checkups, including Pap smears or urine tests. A daily intake of probiotics should be made. Probiotic-rich foods should be eaten. Plenty of fluids should be consumed. You should urinate frequently.

Loose clothing and comfortable underwear should be worn to keep the urethra dry and allow airflow. Avoid wearing tight jeans or materials such as nylon that can trap air and bacteria. Fresh cranberry juice should be drunk. Garlic should be consumed regularly. Clove, myrrh, and oregano oils should be used to help improve UTI symptoms .

In any symptom, you should first go to the doctor. This helps detect infections in their early stages and prevent complications from occurring.