The right kidney is lower than usual. Nephroptosis (wandering kidney). Treatment of kidney prolapse

Nephroptosis- abnormal mobility of the kidney when it leaves its bed and descends into the abdominal cavity. This disease is accompanied by pain in the lower back or hypochondrium, often on the right side. Nephroptosis is dangerous because the kidney can twist around its axis. At the same time, the blood vessels supplying the organ are pinched and stretched. This leads to inflammation and the formation of kidney stones.

Normally, the kidneys are immobile. They can move 1-1.5 cm during breathing and during movements. If the kidney is displaced by more than 5 cm, then this is already considered a pathology.

Omission of the kidney of varying degrees is quite common. Nephroptosis occurs in 1.5% of women and 0.1% of men. It is most often accidentally diagnosed during an ultrasound. Only in 15% of people nephroptosis causes pain.

The average age of patients is 30-50 years, but the disease occurs in childhood. Women are 5-10 times more likely to suffer from nephroptosis. This ratio is associated with the characteristics of the female body, recurring pregnancies and addiction to diets.

Anatomy of the kidney and ligamentous apparatus of the kidneys

kidneys- the most important paired organs of the urinary system, which provide blood purification and maintain the chemical balance in the body.

The kidneys are bean-shaped. The average length of the organ is 12 cm, width 5-6 cm, thickness 3.5 cm. The mass of the organ is 130-200 g. Moreover, the left kidney is usually slightly larger than the right one.

The kidneys are located in the abdominal cavity and are adjacent to its posterior wall at the level of 11-12 thoracic and 1-2 lumbar vertebrae. The kidneys are almost completely covered by the lower ribs. Normally, the right kidney is located slightly lower than the left, and its upper edge is adjacent to the liver. In this regard, in 80% of cases, the right kidney is displaced.

The structure of the kidney. Each kidney consists of a system for the formation of accumulation and excretion of urine. Outside, the kidney is covered with a dense capsule of fat and connective tissue. With their help, the kidney is attached inside the abdominal cavity.

Responsible for fixation of the kidney:

Vascular pedicle consists of the renal artery and renal vein. However, the vessels can stretch, so they do not provide reliable fixation.
Fat capsule, consisting of fatty tissue, protects the body from hypothermia and injury. In women, it is wider and shorter, so it fixes the kidney weaker.
Fascia of the kidney. 2 sheets of fascia of strong connective tissue are located on the anterior and posterior surface of the kidney. They grow together at the upper pole of the kidney and pass into the fascia of the diaphragm. Thus, the kidney is in limbo. The fascia bears the main burden of fixing the organ.
Abdominal ligaments. From the inside, the abdominal cavity is lined with a thin membrane of connective tissue - the peritoneum. Its folds form ribbons - ligaments that fix the organs in the abdominal cavity. The right kidney is supported by the hepato-renal and duodenal-renal ligaments. The left kidney is fixed by the pancreatic-renal and splenic-renal ligaments.
kidney bed, formed by the diaphragm, muscles of the abdominal wall, mesentery of the intestines and fascia.

If one of the components of this fixing apparatus weakens, then the kidney moves down under its own weight.

Consequences of pregnancy and childbirth. After childbirth, the pressure in the abdominal cavity drops due to the weakening of the abdominal muscles, and the kidney loses its support. The larger a woman's belly during pregnancy, the higher the risk of kidney prolapse after childbirth. During repeated pregnancies, the likelihood of developing the disease increases dramatically.
Weight lifting and excessive exercise cause a strong increase in pressure in the abdominal cavity, resulting in stretching of the fixing apparatus of the kidney (ligaments and fascia).
Severe repeated bouts of coughing with whooping cough, tuberculosis, chronic bronchitis. Coughing is accompanied by tension in the muscles of the diaphragm, it goes down, displacing the abdominal organs, including the kidneys, down.
Injuries, falls from a height. Bumps and falls can cause damage to the integrity of the ligaments - tears form on them and the ligaments lengthen. In this case, the fixation of the kidney ceases to be reliable.
Bruises and hematomas displacing the kidney. With a bruise of the lower back, hematomas are formed in the perirenal tissue, which displace the organ and squeeze it.
Sharp weight loss causes thinning of the fatty capsule that supports the kidney.
hereditary predisposition in diseases associated with weakness of the connective tissue (Ehlers-Danlos syndrome, connective tissue dysplasia). With these pathologies, the ligaments are thin and easily stretched, which leads to the prolapse of the internal organs.
Decreased muscle tone of the abdominal wall with a sedentary lifestyle, hypodynamia. The weakening of the muscles leads to the fact that intra-abdominal pressure drops, the kidney comes out of the renal bed and stretches the fascia.
Long stay in the vibration zone. Vibration causes stretching of the ligaments and fascia.
Long-term infectious diseases leading to exhaustion are malignant tumors, tuberculosis, cirrhosis of the liver. The decrease in subcutaneous fat leads to a sharp weight loss and a decrease in intra-abdominal pressure.

Degrees of kidney prolapse

Depending on the course of the disease, three stages of nephroptosis.

First stage. When inhaling, the organ is displaced by 5-9 cm and the lower 1/3 of the kidney is palpated under the ribs. As she exhales, she returns to her seat.
Symptoms of the disease, as a rule, do not occur. But if the kidney is lowered by more than 7 cm, then the fascial capsule is stretched, and there are dull pains that radiate to the lower back. They usually appear when the patient sits up from a supine position.
There are no changes in urine.
Second stage. In a vertical position, the kidney falls below the line of the ribs by 2/3, but when the patient lies down, it returns to its place.
The symptoms become more pronounced. During physical exertion and a change in body position, intense pain occurs, resembling renal colic. Relief comes when the person lies on his back.
Protein and red blood cells appear in the urine. Changes are associated with a violation of the outflow of venous blood from the kidney.
Third stage. The kidney goes below the line of the ribs and can descend to the small pelvis.
The pain is constant, extends to the lower abdomen and radiates to the inguinal region. Sensations do not depend on the position of the patient's body, but are associated with inflammation of the kidneys (pyelonephritis, hydronephrosis).
The urine contains blood and mucus, which is associated with an increase in renal pressure and stagnation of urine in the renal pelvis.

Kidney prolapse symptoms

Symptoms of nephroptosis increase gradually. In the first stage, discomfort or aching pain appears only after physical exertion. Over time, the kidney falls lower, the disease progresses, more and more symptoms appear.

Aching pains in the waist. The lumen of the renal vessels narrows and the outflow of blood and urine from the kidney is disturbed. Edema develops. The enlarged kidney stretches the sensitive fibrous capsule, which contains pain receptors.
Relief occurs if the outflow of blood improves. This happens when a person lies on their back or on their “healthy” side.
In the first stage, discomfort or pain appears when changing posture and in an upright position.
In the second stage, after exertion, severe paroxysmal pain appears, which lasts from several minutes to several hours.
In the third stage, the swelling does not decrease, and therefore the pain is permanent.
Pain in the abdomen, groin, genitals, thigh. When the kidney is lowered, the nerve plexuses that are nearby are irritated. The pains are sharp, cutting in nature, can be mistaken for an attack of appendicitis. They are so strong that a person loses the ability to walk and talk.

Bleeding during urination. When the vascular bundle is twisted, the outflow from the renal veins located in the small cups is disturbed. The wall of the vessel becomes thinner, bursts, and the blood mixes with urine. Urine becomes dark red.

Digestive disorders: constipation and diarrhea, nausea, vomiting, loss of appetite. Violation of the functioning of the organs of the gastrointestinal tract is due to reflex irritation of their nerve endings located next to the affected kidney.

General intoxication: weakness, fatigue, irritability, possible fever during an attack of severe pain. These are signs of intoxication, which develops due to disruption of the kidneys and an increase in the level of toxins in the blood.

Diagnosis of nephroptosis

At the appointment with a nephrologist, a patient

Collection and analysis of complaints. For a correct diagnosis, it is important to clearly describe the sensations: how long ago the problems appeared, the nature of the pain, when and after which it appears.

probing. The kidney is palpated through the anterior abdominal wall below the line of the ribs, as a dense, rounded and painful formation.

Urography of the kidneys- X-ray examination using a contrast agent to determine the stage of the disease. It is carried out in vertical and horizontal position. The study allows you to identify the exact location of the kidney and the condition of its vessels.

kidney ultrasound. Ultrasound examination is considered insufficiently informative. Often it is carried out only in the supine position, when the kidney returns to its place, so it may not reveal grade I and II nephroptosis.

Analysis of urine
- Proteinuria - the appearance of protein in the urine, over 0.4 g / l.
- Hematuria - an admixture of blood in the urine, more than 10 erythrocytes in the field of view.
- White blood cells in the urine (over 5 in the field of view) may indicate inflammation if nephroptosis is complicated by pyelonephritis.

Consequences of kidney prolapse

Venous hypertension of the kidney vessels. Twisting and elongation of the vascular pedicle of the kidney leads to the fact that the outflow of blood is disturbed. The veins of the kidney overflow, the pressure increases in them. The vascular walls become thinner and burst.
Pyelonephritis- inflammation of the kidney. Due to squeezing of blood vessels, insufficient oxygen and nutrients enter the kidney - kidney ischemia develops. Violation of blood circulation leads to a decrease in the protective functions of the body, which contributes to the reproduction of microorganisms and the development of inflammation. Bacteria can be introduced into the kidney with blood flow from any part of the body with bronchitis, sinusitis, pharyngitis. In some cases, bacteria travel up the ureter from the bladder.
hydronephrosis- when the ureter is twisted, urine diversion from the kidney is disturbed. Urine stagnates in the renal tissue, leading to distension of the renal pelvis and calyces. Subsequently, the parenchyma of the organ atrophies and ceases to perform its functions.
Urolithiasis disease . Violation of the outflow of urine leads to the deposition of salts in the ducts of the kidney. Over time, stones of various sizes are formed at this place, which can cause severe pain.

Treatment of kidney prolapse

Treatment of nephroptosis aimed at returning the kidney to the renal bed and fixing it.
Conservative treatment of nephroptosis includes therapeutic exercises and wearing fixing bandages.
Surgical treatment of nephroptosis - these are 150 types of various operations, during which the kidney is sutured to the peritoneum and ribs with synthetic materials or fixed with the help of fascia and muscles.

Gymnastics and exercises to strengthen the muscles of the abdomen and lower back

Therapeutic exercise for nephroptosis It is aimed at strengthening the abdominal muscles and lower back, as well as normalizing intra-abdominal pressure.

A set of exercises for the treatment of nephroptosis

Gymnastics is carried out lying on a flat surface. Starting position - lying on your back. Exercises are performed at a slow pace 5-10 times.

Diaphragmatic breathing. On inspiration, inflate the stomach as much as possible - raise the abdominal wall. As you exhale, draw in your stomach.
Alternately raise straight legs as you inhale and lower as you exhale.
Alternately pull the legs bent at the knee to the stomach as you inhale and straighten as you exhale. A small roll of terry towel can be placed under the lower back to maintain the physiological curvature of the spine.
"Bicycle" exercise to perform 1-2 minutes.
"Scissors". Raise straightened legs at an angle of 45 degrees and perform 1-2 minutes.
"Cat". Get on all fours, bend your back down, and raise your chin up. Stay in this position for 1-2 seconds. Arch your back, press your chin to your chest.
Bend your knees, feet rest on the surface. Squeeze the ball with your knees and linger in this position for 6-10 seconds.
Finish the exercise with diaphragmatic breathing.

Some sports are contraindicated in nephroptosis. Jogging, walking, weight lifting - weightlifting, jumping, equestrianism are undesirable.

Wearing special corsets for nephroptosis

Bandage for nephroptosis increases intra-abdominal pressure, limits the mobility of the abdominal organs and fixes the correct position of the kidneys. It must be worn all day, removing only during gymnastics and at bedtime.

The corset is worn for 3-12 months, during which time the ligaments become stronger and securely fix the organ. However, during this period, it is necessary to simultaneously train the abdominal muscles with the help of gymnastics, otherwise they will weaken during the period of inactivity under the bandage, and the treatment effect will not be achieved.

The purpose of wearing a bandage for nephroptosis strengthen the supporting apparatus of the kidney (ligaments, fascia, fatty capsule), prevent twisting of the blood vessels supplying the organ.

How to put on a bandage? The bandage is put on in the morning, lying in bed. In order for the kidneys to become in place, it is necessary to take a deep breath, and then raise the pelvis and fasten the bandage.

Wearing a corset over underwear is recommended to avoid chafing and ensure sweat absorption.

How to choose a bandage? Universal medical corsets are sold in pharmacies. In most cases, the ruler has 4 sizes. Choose a bandage based on the size of the waist. Thanks to the system of fasteners and Velcro, the corset is tightly fixed on the figure.

Types of bandages

Universal kidney bands. Do not allow the kidney to descend into the abdominal cavity, fixing its position. They are effective at 1-2 stages of kidney prolapse. Such bandages are contraindicated with severe pain and the development of inflammation of the kidneys, as they can worsen its blood supply.
Warm bandages recommended for inflammatory diseases. They are made of wool, retain heat well and activate sensitive skin receptors. This contributes to the expansion of blood vessels, improve blood circulation and a speedy recovery.
Bandages before and after childbirth- Recommended from the 22nd week of pregnancy. Their function is to support the stomach and prevent stretching of the abdominal muscles and a decrease in intra-abdominal pressure.
Postoperative bandages necessary after kidney surgery to fix the organ and reduce the load on the diseased area. In most cases, they are made individually.

Corsets are invisible under clothing and do not restrict movement. They are very effective in the initial stages of nephroptosis, but they must be combined with therapeutic exercises.

Kidney prolapse surgery

Surgery to treat nephroptosis is performed in rare cases in 1-5% of patients. There are strict indications for the surgical treatment of kidney prolapse.

Indications for surgery for nephroptosis

severe pain that disrupts work capacity;
complications (pyelonephritis, hydronephrosis) not amenable to drug treatment;
bleeding from the renal veins;
kidney disease.

Contraindications for surgery

senile age of the patient;
general splanchnoptosis - prolapse of all abdominal organs;
severe diseases that increase the risk of surgery.

Operation technique

All surgical techniques for nephroptosis can be divided into 4 groups:

In the fibrous capsule of the kidney, a seam is made with a kergut and with its help the kidney is fixed to the XII rib and to the lumbar muscles.
Fixation of the fibrous capsule to the rib without stitching it, using flaps of the connective tissue of the capsule or peritoneum. This avoids the formation of a scar on the kidney.
Fixation of the organ with the help of flaps of perirenal fatty tissue, as well as synthetic materials: capron, nylon, teflon. Of these, they form a kind of hammock in which the kidney is located.
Fixation of the kidney to the ribs with muscle flaps.
The last group of operations is the most effective and is used more often than others. The surgeon makes an incision in the abdominal wall up to 10 cm long. He fixes the kidney with a section of the thigh muscle, which was previously taken from the same patient.

After the operation, the patient must observe strict bed rest for 2 weeks. To improve blood circulation, the foot end of the bed is raised by 25-30 cm.

In recent years, laparoscopic surgery has become widespread. Through holes of 1-1.5 cm, thin tubes with a surgical instrument fixed at the end are inserted into the abdominal cavity. With their help, the fibrous capsule of the kidney is sutured. During the procedure, there is no need to open the abdominal cavity, due to which the rehabilitation period is reduced to 5-7 days and the number of complications is sharply reduced.

Prevention of nephroptosis

What do we have to do?

In the absence of kidney complications, there is no need to follow a diet. Nutrition should be varied and complete to maintain immunity.
During pregnancy, wear a support bandage.
Do exercises to strengthen the abdominal muscles.
Several times a day, it is recommended to lie down for a few minutes to improve blood circulation and urine outflow.
Maintain optimal weight.
Strengthen your immune system with a nutritious diet and vitamins.

What should be avoided?

Work associated with a long stay in an upright position.
Long stay in the vibration zone.
Weight lifting.
Trauma in the lumbar region.
Hypothermia of the lower body and legs.
Radical diets and drastic weight loss.

People with the first stage of nephroptosis need to visit a nephrologist at least once a year, undergo an ultrasound of the kidneys and take a urine test. This will help to timely adjust the treatment and prevent further development of the disease.

The kidneys of a healthy person are located on the back wall of the peritoneum at the level of the lower thoracic vertebra, and the right one is about 1.5 cm lower than the left one. This is an indicator of the norm. When the kidney is lowered by more than 5 cm, pain and other symptoms begin, which are often mistaken for manifestations of other diseases.

Why is kidney prolapse dangerous? Is it possible to treat with folk remedies?

Reasons for development

Omission of the kidney or nephroptosis, provoke various reasons. At rest, the filtering organ is motionless, but if the right or left kidney shifts by 1–1.5 cm during breathing or movement, this is normal. An anomaly is a decrease in the organ by more than 5 cm - this is a reason to start serious treatment.

Fixation of the paired organ is carried out by ligaments, fascia and subcutaneous fat. If one kidney is 5 cm or more below the other, the reasons should be sought in the following:

rapid weight loss;
back injury;
systematic weight lifting;
complicated pregnancy;
decrease in the tone of the abdominal muscles;
congenital anomaly in the structure of the kidney;
renal bed.

These are the main reasons why a kidney drops below the level of another. Nephroptosis often affects young women of asthenic physique. The reasons may be as follows: prolonged labor, repeated pregnancies, express diets. All this reduces intra-abdominal pressure, provokes a drop in tone and flabbiness of the abdominal muscles.

Frequent causes of pathology are injuries and infections. The ligaments of the renal apparatus are torn due to impact, falling from a height, strong vibrations. Infection with reduced immunity causes severe consequences, provoking changes in the connective tissue.

Symptoms of the disease

It is possible to determine the prolapse of the kidney when it is displaced by 5 cm. However, the characteristic symptoms begin to appear later. Since the disease proceeds in 3 stages, each has specific manifestations.

At an early stage, the kidney moves down by 5 cm. The organ begins to be felt by one third under the ribs, but at the moment of exhalation it returns to its place. Symptoms do not yet appear, but when the kidney is displaced by 7 cm or more, the stretching of the fascial capsule becomes severe, and there are dull pains that radiate to the back. They increase with a change in body position, with physical exertion, and subside when a person lies down and relaxes. If the right kidney is lowered, then pain and a feeling of heaviness under the ribs on the right side will become characteristic manifestations.

Kidney prolapse of 5 cm or more is accompanied by multiple pathologies:

kidney reversal;
vascular tension;
difficulty in circulation;
kink of the ureter.

All this provokes kidney stones and inflammation in the pelvis. However, these phenomena at first also do not manifest themselves in any way.
With the onset of stage II, the kidney drops by 5–9 cm, and the symptoms of the disease become more pronounced. A person complains of back pain, and when taking a vertical position, its intensity increases. During tests in the clinic, erythrocytes and protein are detected in the urine.

The insidiousness of nephroptosis is that the disease may not manifest itself for a long time, and the resulting symptoms can be easily confused with signs of appendicitis, colitis, cholecystitis. This information is especially important for young women, who are more susceptible to the disease than others.

If one kidney falls below, the pain becomes pronounced only to the II stage of the disease. Therefore, in most cases, people come to the doctor at this time. Patients complain of pain in the lower back, and also in the abdomen or side, nausea and chills. In quite rare cases, the pain syndrome has a cramping character, and blood in the urine is visible to the naked eye. Blood pressure may rise.

Stage III nephroptosis is accompanied by an even greater increase in pain. At the same time, serious violations of the functionality of the kidneys are recorded.

In women, the primary and often the only manifestation of the disease is persistent back pain when taking a vertical position. At the same time, heaviness and discomfort are felt in the abdomen.

Omission of the kidneys is accompanied by a violation of the transport of urine, because there is an inflection of the ureters. Retained urine creates a favorable environment for the reproduction of bacteria, resulting in the development of pyelonephritis and cystitis. They are accompanied by the following symptoms:

pain in the back and abdomen;
fever;
chills;
cloudy urine with a strange smell.

Urine contains calcium and oxalates, which means that when it is delayed in the body, stones will form. They are accompanied by pain in the back and pelvis, vomiting, blood in the urine, painful urination.

If one kidney is located below normal, it becomes extremely susceptible to damage due to blunt trauma to the pelvis and abdomen. In addition, patients are prone to renal colic, which can be recognized by bouts of back pain on the side, nausea, tachycardia, and a sharp decrease in the amount of urine excreted.

Consequences and complications

The omission of the kidneys entails serious consequences. Since there are obstacles to the normal movement of urine, the blood supply to the organ is disturbed, and pressure inside the kidney increases.

Pathology threatens with hydronephrotic transformation, as well as a number of complications:

nephrolithiasis;
arterial hypertension;
pyelonephritis;
cystitis.

For pregnant women, prolapse of the kidneys is dangerous with an increased risk of spontaneous miscarriages.

Treatment with folk remedies

Among the ways to treat kidney prolapse, there are recipes for alternative medicine. They reduce pain and allow you to get rid of the complications that have arisen. But treatment with folk remedies should be carried out in combination with the methods advised by the doctor. In addition, it is important to understand that it is impossible to put the body in its original place with the help of herbs.

roasted plant seeds

If nephroptosis is diagnosed, the patient's condition can be alleviated with folk remedies such as flaxseed, pumpkin or sunflower seeds. They should be sprinkled with powdered sugar and fried in a pan without oil. There are 3 times a day.

Infusion on cochia broom

To alleviate the signs of nephroptosis, the following infusion is suitable. Pour one part of the stalks of broom kochia with three parts of boiling water, close the lid tightly and insist for half a day. Then strain and drink 1 tbsp. l.

Baths with decoction on oat straw

Effective treatment with folk remedies is based on the use of oat straw. Pour one kilogram of powdered ingredient into a large saucepan, pour water and simmer for 1 hour over low heat. Then cool the broth to 38 degrees and prepare a bath with it.

Infusion on onion peel

Onion peel helps with the initial stage of nephroptosis. First, you need to rub it in your hands, and then dial 3 tbsp. l. and pour 1 cup of hot water. After half an hour, the infusion will be ready. Take it 1 tsp. 4 times a day.

Tasty remedy

Non-traditional treatment is not only useful, but also tasty. You can try this recipe: mix 100 g of honey with 1 tbsp. l. butter, 1 tbsp. l. acorn coffee and 4 yolks. There are 2 spoons before a meal.

Bath with Jerusalem artichoke infusion

Sitz baths are widely used in the treatment of nephroptosis with folk remedies. Including Jerusalem artichoke is added to them. 3 art. l. leaves and flowers pour 1 liter of boiling water, leave for half an hour, add to a bowl of warm water. Take a bath for 15 minutes.

Lifestyle with a kidney prolapse

If one of the kidneys goes down, it is required not only to carry out treatment, but also to reconsider your own lifestyle.

Do exercises for the abdominal muscles.
Maintain normal weight.
Follow the diet for complications.
Drink vitamins for immunity.

Lifestyle does not require drastic changes. The main thing is to control the dynamics of your own weight and prevent a deficiency of subcutaneous tissue, since in this case immunity will decrease.

When nephroptosis is prohibited:

Lose weight quickly.
Stay on your feet for a long time.
Lift weights.
Supercool.
Injure your back.

The patient is strictly forbidden to occupy a vertical position for a long time, therefore sedentary work is recommended. The patient should at least once a year conduct an ultrasound examination of the kidneys and give urine for analysis. This will help to correct the treatment in time and prevent complications.

Diet

Diet should not become a way of life for a patient with nephroptosis. However, a special diet is necessary when the disease develops due to the rapid loss of subcutaneous tissue. This often happens during fasting - in girls suffering from anorexia, or in seriously ill patients.

The patient is prescribed a high-calorie diet. Due to fats and carbohydrates, it must restore the integrity of the fatty capsule in which the kidney is located, as well as the turgor of nearby tissues. When the disease is complicated by renal insufficiency, it is important that the food contains easily digestible ingredients that do not leave much waste behind.

Physiotherapy

At an early stage of the disease, special gymnastics should become a way of life for a person. It will complement the treatment and help strengthen the muscles that maintain optimal pressure inside the peritoneum. So the kidney is fixed in a normal position.

It is advisable to do exercises at the initial stage of the disease in order to prevent further prolapse of the kidneys. However, at first it is important to conduct studies of the organ in the clinic in order to assess the state of the excretory function. The doctor will prohibit exercises in case of kidney failure, severe pain and concomitant serious illnesses.

Therapeutic exercise for nephroptosis is simple. A couple of times a day for 30 minutes, it is recommended to do the following exercises (from a prone position):

On inhalation, arms to the sides, on the way out - back (6 repetitions).
Raising straight legs alternately (5 times).
"Walking" lying down (2 minutes).
On inspiration, lifting the pelvis, on exhalation - back (5 times).
Circles with raised straight legs (5 repetitions).
Smooth transition to a sitting position and back (5 times).

All exercises should be done slowly, avoiding overexertion. Yoga and Pilates are also recommended for patients. You can work out both in the fitness club and at home.

Kidney prolapse is a serious pathology that can lead to irreversible dysfunction of the organ. The patient needs long-term treatment and revision of lifestyle. Special exercises should be performed, and for women who are fond of diets for weight loss, it is important to adhere to a high-calorie diet and eliminate the deficiency of subcutaneous tissue. It will not be possible to return the kidney to its place by conservative methods, but if the recommendations are followed, the prognosis is favorable.

The kidney is an organ that has mobility. Normally, it can shift, but not more than a few centimeters. The omission of the kidney is scientifically called nephroptosis. Pathology is characterized by an abnormal displacement of the organ during any movement of a person by two or more vertebrae down. Omission of the right kidney is more common than the left. There is also nephroptosis of the entire paired organ at the same time, but this phenomenon is extremely rare. In the article we will talk about kidney prolapse, symptoms and consequences, causes and methods of treating pathology.

A bit of anatomy

The fixing device is designed to hold the kidney in its normal position. It includes the following structures:

Vessels. They play an insignificant role in fixing the organ, because with nephroptosis they are able to lengthen.
Fat capsule. It is a perirenal adipose tissue that performs a fixing, protective function.
Fascial apparatus. The fascia is located outward from the fatty capsule, consists of the posterior and anterior layers. They grow together at the upper pole and form a suspensory ligament, which passes into the connecting sheath covering the diaphragm. The fascial apparatus plays an insignificant role in the fixation of the kidney.
Abdominal ligaments. These are the folds of the peritoneum that cover the organ in front. The splenic-renal and pancreatic-renal ligaments fix the left kidney, the duodenal-renal and hepato-renal ligaments are designed to prevent prolapse of the right kidney. You will feel the symptoms of nephroptosis if the abdominal ligaments begin to stretch.
Renal bed. It is formed by the diaphragm, fascia, muscles of the abdominal wall.

Causes of nephroptosis

The range of motion of the kidney is normally two to five centimeters (often 3.5 centimeters). But there are certain pathological factors that weaken the fixing apparatus, as a result of which the mobility of the organ increases, and the kidney prolapses.

In adolescence, nephroptosis can be caused by malnutrition. Incorrectly selected physical activity and excessive sports, leading to sharp drops in intra-abdominal pressure, can also become provoking factors. Infectious diseases that occur chronically and are accompanied by weight loss can lead to depletion of the fat capsule that protects the organ from movement.

Kidney prolapse can also be associated with improper organization of labor, which is characterized by a long-term presence of a person in vibration conditions. In addition, nephroptosis often develops as a result of injuries, especially after falls from a height, in which the integrity of the ligaments and fascia is violated. In this case, the fixation of the kidney becomes untenable. The organ can also be displaced by perirenal hematomas resulting from injury to the lumbar region or abdomen.

Nephroptosis and pregnancy

Women who have already given birth may be more likely to develop kidney prolapse than women who have not given birth. This is due to a sharp decrease in intra-abdominal pressure after pregnancy due to weakening of the abdominal muscles. As a result, the fixing apparatus is also weakened, and this is already a factor predisposing to nephroptosis. The risk of pathology directly depends on the size of the abdomen during pregnancy, the degree of stretching of the anterior wall of the peritoneum, the number of births.

Kidney prolapse: symptoms

Patients often do not notice any signs of pathology, and it is usually detected by chance during the examination. Indeed, the clinical manifestations of nephroptosis in the event of its occurrence without a violation of hemo- and urodynamics are extremely scarce. The severity of symptoms mainly depends on the degree of prolapse. Based on the clinical manifestations and characteristics of the pathology, there are three stages of nephroptosis.

First stage

The kidney becomes one third accessible for palpation. Its lower edge is palpable at the height of inhalation, and on exhalation it goes into the hypochondrium. This stage proceeds without a pronounced clinical picture. If the organ is lowered by seven centimeters or more, there may be dull pains radiating to the lumbar region. Their occurrence is associated with stretching of the fascial capsule.

Second stage

Almost the entire organ comes out from under the costal arch. The kidney in the vertical position of the body becomes accessible for palpation by two-thirds, but still, when taking a horizontal position, it returns to the renal bed. As the degree of displacement increases, so does the symptomatology. The pain becomes more intense, reminiscent of renal colic. Unpleasant sensations occur with a sharp change in body position, and during physical exertion. In addition, there are changes in the urine: the level of erythrocytes and protein increases, which indicates stagnation of blood in the kidney due to impaired venous outflow.

Third stage

The entire organ comes out from under the costal arch, lowering occurs up to the small pelvis. The pain becomes constant and often also extends to the groin. Nausea and vomiting may occur. At this time, complications are already developing, including hydronephrosis and arterial hypertension. Due to such complications, as well as due to a long interruption of the blood supply during urination, fornical bleeding can occur. There is a risk of the patient developing psycho-emotional disorders: neurasthenia, insomnia, depression, dizziness attacks, overexcitability, increased fatigue, loss of appetite.

Diagnosis of nephroptosis

In the early stages, as already mentioned, kidney prolapse is often detected by chance, although the patient may consult a doctor with complaints of recurrent lower back pain. The main diagnostic method is urography (X-ray examination with contrast). It is carried out in horizontal and vertical positions. In this way, the degree of nephroptosis can be reliably determined. At a later stage of the pathology, when erythrocytes are already present in the urine, veno- and arteriography (renal vessel studies) are the most informative diagnostic method. They are carried out in a vertical position. This method makes it possible to determine with accuracy how much blood circulation is disturbed in the vessels of the organ.

Kidney prolapse: treatment

Nephroptosis can be treated conservatively and surgically. When choosing the first option, it will not be possible to eliminate the pathology, but unpleasant consequences can be prevented. The patient should use special exercises, eat intensively (but at the same time correctly).

The operation is prescribed only in the case when there are sharp pains and complications that prevent a person from moving and deprive him of his ability to work, such as renovascular hypertension, hydronephrotic transformation, pyelonephritis, fornic bleeding, progressive pyeloectasia.

Conservative therapy

The first thing the doctor prescribes is to wear a bandage when the kidneys are lowered. If you start using it at an early stage of nephroptosis, you can protect yourself from the progression of the pathology and the development of complications. Only in a horizontal position on exhalation should you put on a bandage, do this after waking up, even before getting out of bed.

It is also necessary to perform special exercises when lowering the kidney in order to strengthen the muscles of the anterior wall of the peritoneum. The most effective is the exercise "swallow". Lie on your stomach on a hard surface and very slowly lift your legs brought together, arms and head outstretched to the sides. Fix this position and hold it for a while, and then slowly return to the starting position. Take some rest and repeat the exercise. You need to do at least fifteen to twenty repetitions, then lie on your stomach for a couple of minutes without moving, then turn on your back and rest for at least half an hour. At first, you will feel pain in the kidney area, but it will decrease with each time. But remember: what you are going to perform must be agreed with the doctor.

ethnoscience

As you already understood, neither with the help of drugs nor with the help of exercises will it be possible to eliminate the prolapse of the kidney. Treatment with folk remedies will also not return the organ to its place, but it can prevent and eliminate numerous complications.

With nephroptosis, knotweed infusion should be used. Take it three times a day for one hundred grams half an hour before meals.
It is worth trying this method: sprinkle a handful of flaxseed with water and sprinkle with half a teaspoon of powdered sugar, then fry it all a little in an ungreased frying pan. Chew the seeds like regular seeds whenever you feel like it. It is also very useful to take sunflower and pumpkin seeds, any nuts.
Pour two tablespoons of broom kochia (herb) into a thermos, pour one and a half cups of boiling water and leave overnight. The next morning, strain the resulting infusion and drink fifty milligrams between meals.
Finely chop one kilogram of oat straw with scissors and pour twenty liters of water. Boil for an hour on low heat, then cover and leave for another two hours. Use the resulting warm decoction in the mornings and evenings for taking (every other day). Baths should be taken after the main water procedures are carried out. Infusion is allowed to be used several times.
To increase immunity, take echinacea tincture, eleutherococcus extract, multivitamins.

Surgery

As a result of the operation, the kidney is fixed, that is, its pathological mobility is eliminated. As already mentioned, nephroptosis is not always an indication for surgical intervention, but only in the presence of serious complications. Before the operation, as a rule, for three days the patient is recommended to sleep on a bed with a slightly raised foot end. This helps to return the organ to its normal position and facilitates the process.

During surgery, the kidney is fixed against the muscles of the abdominal wall. There are several methods, the choice of a specific method is carried out on the basis of the clinical picture. After the operation, the patient should also lie on the bed, which has a raised foot end. This is necessary for a faster and more successful recovery. This regimen should be followed for several days, after which the beds are given the usual position, and the patient is allowed to get up and walk.

For another two weeks after surgery, anti-inflammatory therapy is carried out. At this time, the patient should avoid sudden or prolonged straining during defecation. If necessary, microenemas or mild laxatives can be used. It should be noted that in almost all patients the operation is successful.

Consequences of nephroptosis

Kidney prolapse is a pathology that requires mandatory treatment. Otherwise, the likelihood of developing unwanted complications is extremely high. Nephroptosis provokes a violation of the urinary outflow, which, in turn, leads to an increase inside. Even during the period when the pathology does not manifest itself in any way, complications can already arise in the renal parenchyma.

When the normal outflow of urine from the kidney is disturbed, a dangerous disease develops - pyelonephritis. It can disrupt a person's usual life, and sometimes the symptoms are so painful that emergency medical assistance is required.

A kidney prolapse can cause hypertension, which increases the risk of stroke. Among other things, nephroptosis often leads to the formation of kidney stones. Pathology is dangerous for women in case of pregnancy: due to the omission of the organ, spontaneous miscarriage can occur.

Even in a healthy person, the kidney is not always in one place, but moves up and down a few centimeters. This is a normal physiological phenomenon, which should not be feared. However, in some cases, the kidney begins to randomly move in the cavity, sometimes even fixed in another place. This pathology is called "wandering kidney" or, scientifically, "nephroptosis".

The disease is fraught with serious complications and impaired functioning of the body. We will tell you what symptoms a wandering kidney manifests and how you can deal with the problem.

Some anatomy and physiology

The kidney is a paired bean-shaped organ responsible for a number of vital functions in the body. The kidney is located in the lumbar region, on the side of the last thoracic and first lumbar vertebrae.

The kidney does not have a strong fixation, but seems to be suspended on a special ligament. This ensures the mobility of the body. When inhaling, the kidney moves 2-4 cm down, and when exhaling, it rises back. With a deep breath, the displacement increases to 4-6 cm. This feature allows the organ to ensure the normal evacuation of urine from the body. If the kidney were immobile, the urine would stagnate.

In pathology, the ligamentous apparatus is not able to hold the kidney within the normal amplitude. The organ begins to wander - shift to the other side, descend and rise, rotate around its axis in different planes. In some cases, the kidney may move and fix with adhesions. At the same time, blood vessels are twisted, the outflow of urine is disturbed, nerve fibers are touched, pressure occurs on adjacent organs and tissues.

Even if the kidney returns to the anatomically correct place, it usually does not last long. After a while, the organ begins to wander again. Nephroptosis develops.

Causes of a wandering kidney

The causes of nephroptosis are factors that damage the ligamentous apparatus or weaken it. The most common causes:

sudden weight loss;
various kinds of infections;
pregnancy in women;
decreased muscle tone of the anterior abdominal wall;
injury, especially when falling from a height or improperly lifting weights.

In some cases, a combination of two or more factors is necessary to form nephroptosis. In other situations, one reason is enough for the development of pathology.

The disease is characterized by a duration of increase in the intensity of symptoms and the presence of a latent course. There are cases when the patient went to the doctor a few years after the injury or other pathology-provoking factor.

A wandering kidney is a form of nephroptosis. In this disease, pathological mobility of one or both organs is observed.

human kidney

Normal is the mobility of the kidney within one vertebra (this is 1 - 2 cm) during respiratory movements or a change in posture. If the displacement of the organ exceeds this value, then they speak of a wandering kidney or nephroptosis.

This disease can occur in several ways. Sometimes the organ is simply lowered and fixed in that position. This is fixed nephroptosis.

If the organ, in addition to displacement along the vertical axis, easily moves from side to side, then this condition in clinical practice is called "wandering kidney".

This type of nephroptosis is more severe. It is characterized by the development of a sufficiently large number of various complications.

Due to anatomical features, women are more affected by a vagus kidney than men. Also, this condition is very common in old age.

Anatomical features

Physiologically, the right kidney is located slightly lower than the left, in addition, its fixing apparatus is less developed. For this reason, the displacement of the right kidney is observed more often (approximately 80% of cases).

About 10% of cases of this disease are bilateral.

The reasons

The main cause of the wandering kidney is the weakness of the fixing apparatus of the organ. It consists of the following elements:

fatty and fibrous capsules connected with it, which cover the organ from the outside and perform a protective function;
ligaments inside the abdominal cavity;
musculature of the lumbar.

They form the so-called renal bed, the structure of which is different in men and women. In the representatives of the stronger sex, it is conical and narrowed downwards, while in the female half of the population it is cylindrical and wide.

Among the reasons that lead to a violation of the structure of the fixing apparatus and the appearance of the vagus kidney syndrome, there are:

too rapid weight loss due to improper diet, stress or illness. This leads to the rapid depletion of the fatty capsule of the organ;
genetically determined pathologies of the structure of muscle fibers and connective tissue;
regular excessively intense physical activity, weight lifting;
severe injury;
weak, but regular, traumatic impact. A vivid example of this is the appearance of a wandering kidney against the background of a strong cough with whooping cough;
complicated multiple or repeated pregnancy with insufficiently developed abdominal muscles;
atony of muscle tissue in old age, however, in this case, in addition to nephroptosis, pathological mobility of other organs is also observed;
rachiocampsis.

People who suffer from chronic inflammatory diseases of the kidneys are also at risk.

Stages of development of the disease

The shift does not occur abruptly, sometimes a lot of time passes from the onset of the disease to the appearance of significant symptoms of the vagus kidney.

Sometimes, in the absence of a traumatic effect on the organ, the disease may remain at the initial stage and not manifest itself in any way.

The initial stage of the wandering kidney consists in a slight displacement of the organ, which is observed during breathing. That is, it descends on inspiration, but when exhaling it returns to its place.

If a person is thin, then a qualified doctor can even feel the organ through the abdominal wall.

Causes of nephroptosis

Over time, nephroptosis progresses. Kidney prolapse is observed not only during respiratory movements, but also in a vertical position.

However, it returns to its normal location after the person lies down. Starting from this stage, it manifests itself and moves not only up and down, but also twists around its axis.

The third stage is the hardest. The body is displaced very strongly, and no longer returns to its place when taking a horizontal position.

Sometimes there is a shift in the pelvic area. With a wandering kidney, there is a high risk of squeezing the ureters and blood vessels. This causes gradual atrophy of the renal tissue.

Symptoms

Clinical manifestations of the wandering kidney depend on the stage of the disease. Moreover, with the progression of nephroptosis, the symptoms become more severe.

At the initial stage, only slight dull pains in the lumbar region can be observed after physical exertion or intense movements. Pain disappears after taking a horizontal position.

Over time, the pain increases, especially when other diseases are attached to the wandering kidney. There are changes in the clinical analysis of urine: the level of protein and erythrocytes increases.

Renal colic

The third stage of the wandering kidney is very difficult. There are pains according to the nature of renal colic, which no longer disappear even when the person lies down.

Chronic pyelonephritis often develops due to compression of the urinary tract and blood vessels. In addition to the pain syndrome, it is also manifested by a strong fever.

Blood pressure rises, due to a decrease in the functional work of the kidney, general well-being worsens.

Diagnostics

The main danger of the wandering kidney is that, due to the blurred symptoms, the disease is very rarely detected in the early stages.

Nephroptosis can be suspected based on the general structure of a person (excessive thinness) and on the basis of anamnesis data.

Diagnostics

When conducting an ultrasound, it is necessary to compare the results of an examination conducted in a horizontal and vertical position.

The most informative are x-ray studies with the use of contrast. Moreover, all pictures must be taken both lying down and standing.

Radioisotope examination will show the degree of functioning of the kidney, and angiography - the degree of damage to the blood vessels.

To exclude the possibility of prolapse of other abdominal organs, a survey x-ray is taken.

Treatment

There is no medical treatment for a vagus kidney. Perhaps only drug relief of emerging complications.

If the diagnosis of the wandering kidney occurred in the early stages, then regular wearing of a special bandage will help return the organ to a physiological position.

You need to dress it in the morning, lying on your back on a hard surface. Before fastening, you need to exhale deeply.

The main disadvantage of the bandage is the weakening of the muscles of the abdominal and lumbar regions. To prevent this, you need to do special exercises. By the way, such exercises will help to return the wandering kidney to its place.

The most effective are considered to be the “bicycle”, known for sure to everyone, raising straight legs while lying on your back, “scissors”.

Therapeutic exercises

It is also very useful to strengthen the back with the help of the “swallow” exercise. To do this, lying on your stomach, you need to tear your arms and legs off the floor and hold this position for as long as possible.

However, it is better to start gymnastics under the supervision of a qualified specialist in a special exercise therapy room, and only then do it yourself.

They also limit any physical activity, prescribe a diet that is gentle on the kidneys.

With the ineffectiveness of all these methods, an operation is performed, which is called nephropexy. It is performed laparoscopically through small incisions on the surface of the abdominal cavity.

In this case, the surgeon has the opportunity to visually observe the progress of the operation. During the manipulation, the wandering kidney is attached to neighboring tissues.

Previously, for these purposes, an abdominal operation was performed, which threatened the development of various complications and a long postoperative recovery.

Prevention

The main preventive measures to prevent displacement of the kidney are to strengthen the muscles of the back and the press. In addition, you should dose physical activity and correlate it with your physical condition.