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hydronephrosis
Dilation of the renal pelvis & calices, & sometimes, collecting ducts.
Etiology:
1) obstruction of urine flow by
a) urinary calculi
b) tumors
c) neurologic disorders
d) congenital anomalies
2) pregnancy (may be normal finding)
Pathology:
1) obstruction of urine flow (obstructive uropathy)
2) vesicoureteral reflux
3) dilation of the renal pelvis & calices, & sometimes, collecting ducts
Clinical manifestations:
1) may be asymptomatic
2) symptoms related to obstructive uropathy
Laboratory:
1) urinalyis, 24 hour urine protein if indicated
2) serum creatinine
Special laboratory:
- post void residual
Radiology:
1) CT of abdomen
2) abdominal US
3) diuretic renogram: obstruction slows washout of radionuclide (0.5 mg/kg of furosemide prior to radionuclide renal scan)
Management:
1) consider surgery in a patient with pain & a positive diuretic renogram
2) no treatment is necessary in an asymptomatic patient
Related
postrenal azotemia; obstructive uropathy
vesicoureteral reflux
General
kidney disease; renal disease
sign/symptom
References
- UpToDate version 15.1
http://www.utdol.com
- Lusaya DG and Schwartz BF
Medscape: eMedicine: Hydronephrosis and Hydroureter
http://emedicine.medscape.com/article/436259-overview