- Causes of nephroptosis
- Danger to the body
- Symptoms of nephroptosis
- Nephroptosis during pregnancy
- Kidney Shift Complications
- Diagnosis of nephroptosis
- Nephroptosis treatment
- Prevention of kidney prolapse
Nephroptosis is a condition characterized by a pathological increased mobility of the kidney. It is normal for the body to move vertically within 1-2 cm. With the development of nephroptosis, the kidney can move freely from the retroperitoneal space into the stomach or pelvis, returning to its place on its own.
Causes of nephroptosis
Doctors identify a number of predisposing factors that lead to the development of nephroptosis:
- rapid and drastic weight loss;
- injury to the lower back or abdomen. During the stroke, ligaments that hold the kidney in the retroperitoneal space may be damaged;
- pregnancy and childbirth in women. During gestation, the woman's body undergoes constitutional changes, characterized by a weakening of the muscles of the abdominal wall;
- obesity and rapid weight gain.
Danger to the body
Each kidney includes large blood vessels - the renal artery and vein, and the ureters leave the kidney. The vessels are almost wide and short in structure. With the displacement of the kidney from its physiological space, the organs of the body have to narrow and stretch. As a result, the normal blood circulation in the kidney is severely impaired. In addition, the displacement of the kidney leads to the bending of the ureter, which threatens acute retention of urine in the body. All these deviations from the norm create prerequisites for the development of a serious inflammatory process of the kidney - pyelonephritis.
Symptoms of nephroptosis
The clinical picture of the disease depends on the stage of nephroptosis. Urologists distinguish three stages of nephroptosis:
- Grade 1 nephroptosis is characterized by the absence of complaints and clinical symptoms. On palpation of the abdomen, the doctor may feel a kidney there.
- Grade 2 nephroptosis is characterized by the appearance of pain in the lumbar region of a pulling and aching character. Sometimes pains occur in the form of attacks, increasing with a change in the body position of the patient. On examination by a doctor, the kidney can be felt freely in the hypochondrium. In the analysis of urine revealed protein and elevated levels of red blood cells. Urine is turbid.
- Grade 3 nephroptosis is characterized by severe pain. The discomfort and pain bother the patient almost constantly. In parallel, there may be manifestations of dyspepsia - nausea, vomiting, increased salivation, impaired stool. The patient becomes irritable, complains of severe fatigue and anxiety. The kidney can fall to the pelvic area. Clinical analysis of urine shows abnormalities, while the urine itself is turbid and has a sharp odor.
Nephroptosis is unilateral and bilateral. Most often in urology unilateral right-sided nephroptosis occurs. The displacement of both kidneys is very rare and is more often caused by a congenital anomaly of the ligamentous apparatus of the kidneys. Pain in this disease can occur after intense physical exertion or weight lifting. Over the years, the patient's condition only worsens. Pain syndrome can be triggered by even a regular cough or sneezing. Often, on the background of nephroptosis, patients develop renal colic, during which the patient becomes restless, cannot take a comfortable posture, becomes covered with cold sweat. An attack of renal colic provokes reflex muscle contraction and can lead to vomiting, involuntary urination and defecation. The skin of the patient with an attack turn pale, there is a decrease in blood pressure and heart palpitations.
Nephroptosis during pregnancy
Very often, this pathology occurs in women during pregnancy. If the woman had nephroptosis even before the onset of pregnancy, but did not manifest itself clinically, then the patient’s condition is only aggravated after giving birth. Even if there was no nephroptosis before, then after childbirth, this condition can develop against the background of stretching of the ligamentous apparatus of the kidneys and weakening of the abdominal muscles.
To avoid this disease during pregnancy and after childbirth, the expectant mother should do simple physical exercises daily, aimed at strengthening the muscles of the pelvic organs and the anterior abdominal wall. Of course, before the start of classes, it is necessary to obtain permission from the local gynecologist leading the pregnancy. If a woman is at risk of miscarriage, then all physical activity is excluded.
In addition, it is important to understand that in itself, the proliferation of the kidney does not pose a threat to the life of the growing fetus, but the effects of an organ shift can adversely affect the course of pregnancy as a whole. That is why all pregnant women regularly undergo a comprehensive examination, necessarily including an ultrasound of the pelvic organs and retroperitoneal space, urine and blood tests. This approach allows you to identify any deviations from the norm at the initial stage of their development, and promptly started treatment eliminates the risk of complications that pose a threat to the fetus. The progression of the pathology of the urinary system is an indication for the urgent hospitalization of a pregnant woman, since with the development of renal failure natural gestation and delivery are impossible.
Kidney Shift Complications
In the absence of timely medical care, the progression of nephroptosis can lead to the development of serious complications:
- Pyelonephritis - develops against the background of stagnation in the kidneys, creating a favorable environment for the reproduction of pathogenic microflora, which in turn cause an inflammatory process in the renal pelvis system.
- Hydronephrosis - develops due to violations of the outflow of urine due to the inflection of the ureter or its torsion.
- Secondary arterial hypertension - develops as a result of impaired physiological blood circulation in the kidney. With the development of this complication, hypertension is poorly amenable to correction with medical drugs.
Diagnosis of nephroptosis
When a diagnosis is made, the collection of the patient’s history is of paramount importance. At the reception, the patient should tell the doctor about the traumas and injuries of the lumbar region, inflammatory and viral diseases, well-being, frequency and intensity of pain. Be sure to mention the strengthening or subsiding of pain when changing position of the body and during exercise.
The doctor conducts a general examination of the patient - palpating the lumbar region and the anterior abdominal wall. Palpation should be carried out not only in the horizontal position of the patient's body, but also in the vertical. Often it is in this way that nephroptosis can be detected.
In order to clarify the diagnosis, the doctor prescribes the patient to undergo additional examinations - x-rays and instrumental examination. The simplest and most accurate way to determine nephroptosis is ultrasound and radiography of the retroperitoneal space and abdominal cavity with the introduction of a contrast agent intravenously.
Additional methods for the diagnosis of nephroptosis are excretory urography, angiography and pyelography. These studies are carried out in vertical and horizontal positions of the body. Thanks to modern apparatuses and diagnostic methods, it is possible not only to confirm the kidney prolapse, but also to accurately determine the degree of development of the disease.
Conservative and surgical methods of treatment are used to treat kidney prolapse. Conservative treatment of nephroptosis is possible at the initial stage of the development of pathology and consists in performing physical exercises, adherence to a special diet, wearing a bandage and a course of massage. The bandage should be worn daily, dressing it in the morning, in the prone position, after taking a deep breath. For each patient, the bandage is chosen strictly individually and can be made specifically for the order.
Contraindications to wearing a bandage are adhesive processes in the abdominal cavity, in which the displaced kidney is fixed in one place.
Physical therapy for the displacement of the kidney is a complex of exercises that are aimed at strengthening the muscles of the anterior abdominal wall and lumbar region. These exercises contribute to the creation of normal pressure in the abdominal cavity, due to which the kidney can stay in a physiological position. Physical exercise must be performed in the morning, on an empty stomach, after having drunk a glass of pure water without gas. The main part of the exercises is performed in the supine position, so the patient must first prepare a place to practice and lay a soft mat. All exercises should begin with a breathing exercise. The total duration of physical therapy should not exceed 20 minutes.
In addition to exercise the patient is shown adherence to a special diet. Food should be high in calories and contain a small amount of salt. Each patient's diet is signed individually, depending on the degree of kidney prolapse, the physique of the patient and a number of other factors.
Surgical intervention is necessary in the case when nephroptosis occurs with complications. Complications of kidney prolapse include the following conditions:
- long and intense pain that interferes with the patient's normal lifestyle;
- the development of chronic pyelonephritis;
- disruption of the urinary system;
- the appearance of a large number of red blood cells in the analysis of urine;
- persistent increase in blood pressure.
For the operation of the patient is prepared for 10-14 days. During this period, the patient is prescribed anti-inflammatory drugs to prevent the spread of the pathological process and pathogenic microflora with blood flow throughout the body. A few days before surgery, the patient is recommended to occupy a position in bed with a raised foot end. This is the position that the patient should occupy for several days after the operation.
During the operation, surgeons fix the displaced kidney in a normal position, which at the same time maintains its physiological mobility. After the operation, the patient is prescribed light laxative medications in the next 2 weeks of the rehabilitation period, in order to avoid excessive tension of the muscles of the anterior abdominal wall during an act of defecation. As a rule, the outcome of the operation is always favorable. In a larger number of patients, there is complete recovery. Within six months after the surgery, the patient is limited by physical exertion.
To date, laparoscopy is used for the surgical treatment of nephroptosis. Such an operation is more easily tolerated by patients, in contrast to abdominal intervention. In addition, laparoscopy significantly shortens the rehabilitation period.
Yoga classes for kidney drop
In the course of the research it was found that yoga classes have a beneficial effect on the abdominal muscles and lumbar region. Many exercises are able to strengthen the ligamentous apparatus of the kidney, thereby returning it to its place. Of course, this is relevant in the initial stages of the development of pathology.
Prevention of kidney prolapse
To prevent the development of nephroptosis, you must carefully consider your health. This is especially true for pregnant women who are at risk. Timely registration for pregnancy, regular examinations by a gynecologist will help identify the disease at the initial stage of development, which increases the chances of a successful outcome of treatment and prevents the development of complications.
If a person is injured in the abdomen or lumbar region, then it is imperative to see a doctor!
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