Hydronephrosis in children

Hydronephrosis of the kidneys in newborns occurs with a frequency of one percent among all born babies. However, the danger of this disease requires special attention to its treatment. Kidney hydronephrosis in children is a pathology that is characterized by the expansion of the renal pelvis system due to the accumulation of fluid in it. In male babies, it develops much more often than in girls.

Hydronephrosis in children

Types of hydronephrosis

There are congenital hydronephrosis and acquired. Hydronephrosis in children is usually congenital.

It is also divided into 3 degrees according to the severity of the manifestation:

  • The first degree does not produce any symptoms, the renal function is not impaired, only the pelvis is expanded, but only slightly.
  • The second degree is characterized by a decrease in kidney function by about 40%, the pelvis expands significantly, the kidney grows in volume.
  • In the third degree, the work of the kidneys

and impaired, the excretory function suffers, renal failure may develop, the organ becomes very large compared with the original size.

Causes of hydronephrosis in children

In the normal functioning of the urinary system, all urine from the kidney is regularly removed from the body through the ureter and bladder. An additional vessel that puts pressure on the ureter can interfere with the removal of urine. As well as violations of urine excretion may be due to a change in the normal structure of the ureter (excessive narrowing), as well as its location. As a result, the fluid remains in the kidney and significantly stretches it.

Hydronephrosis in children

Numerous studies have shown that hydronephrosis in newborns is closely related to the fact that the mother smoked and her alcohol was consumed during the period of carrying the baby.

Uncontrolled use of drugs also has an impact on the development of kidney disease. There is an opinion that the harmful effects of the environment on a woman can also lead to hydronephrosis.

Clinical picture

Symptoms of hydronephrosis at an early stage are absent or mild, especially in a one-way process. In this case, a healthy kidney works for two. If hydronephrosis is bilateral, then signs may appear at the first degree. First of all, pain occurs in the lumbar region, with the introduction of bacteria may increase the temperature of the body.

There may be blood impurities in the urine. With the aggravation of the process in the lumbar region, an enlarged kidney can be felt, the tummy of a newborn becomes larger. While the child urinates, he cries, screams. As a result of violation of urine outflow in the baby’s body, metabolic products accumulate. What causes pronounced itching of the skin.

The dropsy of the kidney on the left does not differ in the clinic from the right-sided process.

Hydronephrosis in children

Diagnosis of kidney hydronephrosis in children

The hydronephrosis of the left kidney in a child develops in more cases than the hydronephrosis of the right kidney. To make an accurate diagnosis, you must pass routine tests: blood, urine and biochemistry.

Ultrasound is the main diagnostic method, and it enables the detection of hydronephrosis in newborns in the womb from the 15th week. The main feature is an increase in kidney size. If the doctor detects this symptom, then the baby is observed in utero on an ongoing basis. If there are signs of dropsy of the kidney after the baby is born, he is prescribed a specialized treatment.

In addition, for the diagnosis using the method of excretory urography, to compare the excretory capacity of both kidneys. There is also a diagnostic method of mist cystourethrography. The essence of the technique is the introduction of contrast, which absorbs X-rays well into the bladder. During the time when the child urinates, pictures are taken on the basis of which one can judge the structure of the organs, the presence of a reverse flow of urine. And when in doubt, computed or magnetic resonance imaging is used.

How to treat?

Treatment of hydronephrosis in children consists only of surgery, with which it returns back the normal flow of urine. In newborns, hydronephrosis can resolve itself up to a year. That is why the baby is examined every three months. However, this monitoring method is used only for the first and second degrees of hydronephrosis. At the third – urgent treatment is necessary. Most often the operation for hydronephrosis is performed by endoscopic technique. With this method, two small incisions are made, through which the endoscope and the necessary devices are inserted. Endoscopy is less traumatic than abdominal technique.

If the violation of patency is located at the level of the ureter, then make it plastic. The effect of such surgery is quite high. If there is a large amount of fluid inside the kidney, it is removed using catheterization.

After the end of the operation, the child is given a drainage system; it can be external and internal. If the surgeon puts the internal drainage system, then the discharge of the baby from the hospital occurs on average a week later. And with the external system, the baby spends about a month in the hospital. During the period of rehabilitation after hydronephrosis, antibiotics and uroseptics are indicated. The baby must be in the dispensary registration to the urologist. Urinalysis after surgery should be taken every two weeks for six months. Even after 6 months, leukocytosis may be present in the urine, however, this is not a cause for concern.

Sometimes the operation is performed on a child in the womb, but this technique is very dangerous, it can lead to miscarriage.

Neonatal hydronephrosis outcomes

The outcome of the disease is greatly affected by the timeliness of its detection. If the process is bilateral, the frequency of complications increases. With unilateral hydronephrosis, treatment is a great success.

Among the complications, pyelonephritis is the first in frequency, which occurs against the background of a joining infection. Also, hydronephrosis is often complicated by intoxication of the body due to insufficient excretion of metabolic products. The most serious result of hydronephrosis is renal failure. It requires further use of hemodialysis (blood purification procedure using a special membrane) for life or transplantation of a donor kidney.

Conclusion

Hydronephrosis is a serious disease, this condition requires immediate treatment, otherwise the child may develop renal failure and, as a result, disability. Dear parents, if you have any doubts about the health of your child’s kidneys, be sure to show him to the doctor.

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