Wandering kidney– pathology of the urinary system, which is characterized by excessive movement of the renal organ outside the anatomical bed.
Due to high mobility, the kidney can drop significantly downwards, reaching the pelvic area.
A mobile kidney is more characteristic of women due to the characteristics anatomical structure body. Elderly people are also susceptible to this pathology.
Both kidney organs are naturally mobile, but they normal deviation from the usual place is no more than 1-2 cm.
If the displacement of the kidney exceeds this figure, doctors diagnose a pathology such as nephroptosis, a type of which is a wandering kidney.
Wandering kidney in the picture
Because the left kidney is located above the right one, then the mobility of the latter is slightly higher, so it is the right kidney that is more often diagnosed as wandering.
Doctors currently cannot say with absolute certainty what specific causes provoke this pathology.
Normally, the kidneys shift during the act of breathing: by 3-4 cm when inhaling, by 5-6 when exhaling. Also, with various body movements, they are also capable of shifting. This determines the normal outflow of urine. There are situations in which the kidney is not able to stay in its designated place.
This may happen when poor performance its fixing elements, among which are:
- lower back muscles;
- ligamentous structures abdominal cavity;
- fatty tissue and fibrous capsule.
All of the above components form the kidney bed; it differs in appearance in males and females. For the former it is cone-shaped, and for the latter it is cylindrical.
The main causes of a wandering kidney:
- sudden weight loss, which depletes fatty tissue near the kidney;
- serious injuries;
- hereditary failure in the structure of the muscle corset and connective tissue;
- constant exhausting physical activity with lifting heavy objects;
- a short break between two pregnancies or carrying several babies at the same time;
- curved spinal column;
- decreased muscle tone in old people.
If the kidney for a long time is in a place uncharacteristic for it, then when adhesions form, it can be fixed there.
Stages of the disease
The wandering kidney can be classified into several stages. In its development, three stages of the pathological process are distinguished.
The first stage in which the wandering kidney can be identified by palpation.
The kidney is palpated on inspiration. As you exhale, it moves to the right hypochondrium. Usually seen in thin people!
At the second stage, the kidney can move from the hypochondrium. At the same time, in a lying position, it returns to the same place.
The third stage is characterized by the fact that the kidney descends. Namely - in the small pelvis.
At the first stage of this disease, displacement of the kidney may not cause any symptoms other than dull pain in the lumbar region, aggravated by physical activity. Already at the second stage of nephroptosis, the kidney is able to rotate around its axis, which leads to the development of various complications.
Kidney prolapse has degrees that are distinguished based on its severity:
- The first degree is characterized by the fact that the mobile organ can be palpated through abdominal wall during inspiration (if there is no nephroptosis, then the kidney can only be detected in thin people).
- The main symptom of the second degree is the protrusion of the kidney from under the ribs in a standing position; in a horizontal position, it hides again.
- The third degree is distinguished when the kidney appears from under the ribs in both vertical and horizontal positions of the person, and it is also capable of wandering in the small pelvis.
In children
Nephroptosis in children is a rare phenomenon. It was believed so, according to at least, quite a long time ago. Now the process is quite common.
The wandering kidney is observed on the right. Than on the left in children. More often the disease affects girls. Boys are less susceptible to the disease.
What is the etiology of the disease in children? The most common reasons include:
- - heredity;
- - thinness;
- - respiratory diseases;
- - injuries
All these factors, one way or another, contribute to morbidity. It is known that heredity is a common cause. Since with nephroptosis, the mother’s child will certainly fall ill.
In adults
Nephroptosis can appear at any age. This pathological condition kidneys is observed mainly in women. Although there are cases of manifestation in men.
According to statistics, in 2% of cases the disease affects women of childbearing age. More often during pregnancy. Or under the influence of infections or injuries.
What else could cause the process? The disease can develop due to an anatomical predisposition. Let's say the building female organs, one way or another, promotes wandering of the kidney.
It is known that women have a certain pelvic structure. More wide pelvis and decreased tone of the abdominal wall.
In adults, the kidneys are in a mobile state. When you inhale and exhale, they move a certain number of centimeters. This directly contributes to the physiological excretion of urine.
The insidiousness of the disease is that with the duration of the location of the kidney. It can be fixed in a certain place for a long time.
Signs of a moving kidney
Symptoms of the disease
The main difficulty in identifying nephroptosis is the lack of characteristic and severe symptoms. As a rule, the development, course, variations and severity of the symptom complex are individual in each case. The most common symptoms include:
- fast fatiguability, weakness, insomnia, frequent dizziness;
- constipation, diarrhea, feeling of heaviness in the abdomen, bloating, decreased or complete absence appetite;
- frequent mood swings, hysteria, hypochondria, neuralgia of the femoral, regional and sciatic nerves;
- presence of hematuria, increased and rapid heartbeat, sharp jumps blood pressure;
- the formation of pyelonephritis, cystitis, urethritis, pain similar to renal colic, heaviness in the affected side of the lower back, the presence of protein in urine is possible;
- pain in the kidney area, main feature is the disappearance or decrease in the supine position.
For information! Increased mobility on the right affects the right side, on the left - the left side.
The very first symptom is pain in the hypochondrium. A person may also experience a feeling of heaviness in the area of the diseased kidney. When lying on your back, these symptoms weaken or even disappear completely. When palpating the abdomen under the free edge of the ribs, a kidney can be felt with nephroptosis. Pressing on it is quite painful.
Other symptoms of a wandering kidney:
- irritability, short temper;
- neuralgic pain.
Nephroptosis is a urological disease that affects the urinary system, resulting in active mobility of the organ and its gradual prolapse. A wandering kidney (nephroptosis) is the first sign of urolithiasis, arterial hypertension, pyelonephritis, hepatic colic and others urological diseases. In this article we will tell you why a floating kidney is dangerous, we will analyze the symptoms of the pathology and treatment methods.
Characteristics of nephroptosis
The pathology “walking kidney” is quite complex and has various complications
Exist acceptable standards mobility of the organ, they allow the kidney to shift by 1-2 vertebrae in the process of breathing movement and changing posture. If this norm exceeds the permissible value, nephroptosis or kidney mobility is established. Pathology can occur in two ways:
- fixed nephroptosis - characteristic feature consists in lowering the organ and its strong fixation;
- wandering kidney - a characteristic feature is vertical displacement and constant movement of the organ from side to side.
For information! The pathology “walking kidney” is quite complex and has various complications.
According to statistics, women suffer from this disease more often than men, this is caused by a peculiarity of the anatomical structure. As a rule, the disease manifests itself in adulthood. Displacement of the right kidney occurs more often than the left; this is due to a physiological feature and the underdeveloped fixation apparatus of the organ.
For information! Only 10% of nephroptosis is bilateral.
It is worth noting that fixation of the kidneys in a certain place occurs subject to such factors as:
- presence of renal fascia;
- support of the renal bed, consisting of the quadratus lumbar and psoas muscles;
- vascular system kidneys, providing interaction with the aorta and inferior vena cava.
You can learn more about the wandering kidney from the video and the article “What is kidney nephroptosis.”
Many people explain frequently recurring lower back pain as fatigue after physical activity, but could it be something more dangerous? The pain is not constant: it is present in a vertical position, but disappears in a horizontal position, which is very similar to the symptoms of kidney prolapse.
Lower back pain is a symptom of kidney prolapse
Is this disease serious? When does it occur, how does it manifest? Information about the disease will help you avoid serious consequences, they will tell you how to improve your life so that the illness does not interfere with your normal life.
Reasons for the development of kidney prolapse
Nephroptosis is the name of a disease in which a person’s kidneys may not be located where they should be according to physiological standards. One or two kidneys can be prolapsed. Women are more susceptible to the disease and prolapse of the right kidney is diagnosed in them much more often.
Keep in mind! Kidney prolapse occurs when their natural support is disrupted. In people with flabby abdominal muscles or their body weight is much lower than normal, pathology occurs much more often in comparison with people who have a standard physique, go in for sports, and are not into dieting.
We can talk about nephroptosis if there is a downward displacement of two or more centimeters. A displacement of up to 1-2 cm is not considered a pathology, since for healthy kidney Mobility is normal.
Location of healthy kidneys
Let's look at the diagram of human physiology, where exactly the kidneys are located and why they can descend. Their place is back wall abdominal cavity on the sides of the spine at the level of the first lumbar vertebrae, below the thoracic. Almost always omitted right kidney compared to the left by 1-1.5 cm. In the normal position, they are held by the ligamentous apparatus - the renal bed, the renal pedicle and the membrane attached to the lateral parts of the spine. The renal membrane consists of:
- the connective fibrous capsule is a thin smooth plate adjacent to the kidney substance itself;
- fat capsule – adipose loose tissue;
- connective tissue fascia.
The kidney is fixed in the renal bed precisely due to the membrane and a certain intra-abdominal pressure arising from the abdominal muscles and diaphragm. The neurovascular bundle approaches it and the ureter departs.
Location of the left and right kidney in a healthy person
Symptoms of kidney prolapse may develop:
- Due to weak ligamentous apparatus kidneys
- After injuries sustained in areas of the body near the kidneys. As a result, the kidney is pushed back due to damage to the ligaments and the formation of a perinephric hemangioma.
- Due to weakening of the abdominal muscles. The most common reason, which reduces muscle tone - multiple or not the first pregnancy.
- With a sharp and significant decrease in the thickness of the fat capsule, which can happen after infectious disease or a sharp decrease in body weight.
Attention! Women who have given birth are always at risk, but this does not mean that the birth of a child always leads to problems with the mother’s health. Kidney prolapse during pregnancy depends on the number of births and the size of the abdomen. A predisposing factor is a weakening of the fixing apparatus of the kidneys, since in pregnant women intra-abdominal pressure sharply decreases due to weakened abdominal muscles.
Diagnosis of kidney prolapse
It is important to know that clear clinical symptoms are present in only 15-20% of patients. Wandering kidney syndrome (another name for this pathology) does not occur in children with rare exceptions, and in adults it manifests itself mainly at the age of 20-40 years. The patient's complaints alone are not enough to establish accurate diagnosis. Urinalysis, ultrasound and special research methods are required. Kidney mobility is confirmed by urography - x-ray examination urinary tract. Please note that urography can be survey, excretory, or infusion. In the first case, this is an ordinary x-ray, in the second and third – the same x-ray, but with contrast agent, which is administered intravenously to the patient. It is important that the doctor inquires from the patient about the presence allergic reactions. The doctor must do a test before administering the drug. For control, a solution of a dye is injected into one forearm, and a saline solution into the other.
How is urography performed?
Symptoms of a wandering kidney
In urology, there are three stages of the disease. Regardless of the cause, kidney prolapse may manifest itself as follows:
- Stage 1 – no or mild pain nagging pain in the lower back, which may worsen with physical activity. The violation occurs only if the person is in an upright position. If the patient lies down, the kidney will return to its place and the pain will subside.
- The second stage – pain in the abdominal area is already prolonged and pronounced, which indicates the progression of nephroptosis. Urinalysis shows protein and red blood cells. The prolapse is accompanied by stretching and twisting vascular bundle and ureter. The lumens of the renal arteries and veins narrow by half. The pathology is accompanied by impaired renal hemodynamics and difficulty urinating.
- The third stage - all the above symptoms intensify. Pyelonephritis develops - inflammation of the kidney due to severe ischemia of the renal tissue, venous hypertension and edema. Stagnation of urine may occur with a deformed ureter. Pathological fixation of the kidney due to adhesions cannot be ruled out. The pain does not go away when lying horizontally; an emotional component is added to it.
The symptoms of prolapse of the right kidney are similar to the pathology of the left kidney, but the localization of pain, naturally, is with right side the patient's body.
Consequences of kidney prolapse
Nephroptosis in itself is not terrible, but it can lead to serious consequences in the form of complications. The patient must understand that the prognosis of his illness is unfavorable if he does not will take the course treatment and will not follow the doctor’s recommendations. The most common complications of wandering kidney syndrome:
- fornical bleeding;
- orthostatic arterial hypertension;
- perinephritis;
- hydronephrosis;
- pyelonephritis.
Urologists have unsightly medical statistics. IN last stage prolapse of the right or left kidney ends in complete loss of working capacity. It's time to think about your health, because timely treatment can reduce complications to a minimum. Do not forget that recovery depends not only on the qualifications of the attending physician, but also on how well his patient follows the instructions. Be healthy, take care of yourself!
April 27, 2017 Doctor
A wandering kidney is a form of nephroptosis. The disease is characterized by pathological mobility of one or both internal organs. Normally, the mobility of the internal organ within one vertebra is 1-2 cm (when changing posture, lifting heavy objects or during breathing movement), but if the displacement is significantly greater than the specified ratio, then we are talking about displacement of the kidney.
Of all varieties kidney diseases nephroptosis occurs in medical practice rarely. Women are most susceptible to the development of pathology - due to physiological characteristics, as well as elderly people. A wandering right kidney is more often observed (80% of all cases), since it is located in the body somewhat lower than the left internal organ, and its fixing apparatus is underdeveloped. Approximately 10% of cases of this disease is two-way in nature.
The disease can occur in various options. If the kidney just drops and remains in one permanent place, then this is fixed nephroptosis. This type pathology is much more severe, moreover, it can cause serious complications.
The kidneys in the body are supported by fat capsules, muscle structures, ligaments and fascia. The diaphragm and muscles create intra-abdominal pressure, which helps to fix the internal organs. The main reason for the development of pathology is the weakness of the fixation apparatus.
Reasons and factors provoking weakening of the fixing apparatus and leading to displacement of the internal organ:
- Rapid depletion of the fatty capsule of the kidney occurs as a result sharp decline weight due to illness, stress or strict dieting;
- Genetic changes and pathologies in the structure of connective tissue and muscle fibers;
- Regular lifting of weights;
- Intense physical activity;
- Injuries;
- Frequent and multiple pregnancies, leading to weakening of the abdominal muscles;
- Atony of the bladder in the elderly;
- Rachiocampsis.
Connective tissue pathologies can be acquired or congenital. The acquired form of the disease often develops against the background of the activity of infectious processes in the kidneys with damage to nearby tissues. Congenital pathologies are caused by the presence of excessive extensibility of connective tissue.
Stages of development
The displacement of the kidney occurs gradually. As a rule, from the onset of the disease to the manifestation pathological symptoms a lot of time passes. Often the disease remains initial stage development and does not manifest itself in any way if there is no impact negative factors(trauma, inflammation).
The stage of kidney displacement can be different, they are all characterized by individual characteristics:
Signs of kidney nephroptosis by stage
Clinical symptoms of a wandering internal organ depend on the stage of the pathology, with the progression of the disease leading to a more severe condition for the patient.
- Stage 1 may be asymptomatic or signs of pathology will be minor ( It's a dull pain in the affected area, heaviness in the abdomen). During physical activity or lifting weights, the pain becomes more active; if the patient is in a supine position, the symptoms disappear.
- Stage 2 is equipped with more striking signs. Pain in the lower back gradually increases and “invades” the abdominal or back areas, the patient has no appetite, and when pressure is applied to the displaced kidney, the pain becomes sharp.
- Stage 3 is characterized by widespread pain, spreading to groin area, abdomen, lower back, renal colic appears, blood pressure rises, gastrointestinal function is disrupted (diarrhea or diarrhea). In more complex cases, the patient exhibits mental disorders. Painful symptoms present in any position.
Treatment methods
A wandering kidney cannot be cured using medicinal methods. Reception medicines only relieves the symptoms of the pathology. The main purpose of medications is aimed at:
- normalization of blood pressure;
- reduction of pain syndrome;
- suppressing the risk of development and reproduction of pathogenic microorganisms.
Conservative
On early stage nephroptosis, wearing a special bandage is indicated. The belt is put on the patient when he is in a supine position and is fixed while inhaling. It is recommended to wear the bandage during the day and remove it at night. The best option is the selection of a bandage according to custom sizes the patient's body, but modern medicine offers belts with adjustable buckles that can be easily adjusted to fit your body.
The main disadvantage of the bandage is the weakening of the muscles of the lumbar and abdominal regions. To prevent this process, it is recommended to perform special physical exercise, which contribute to the return of the displaced organ to its place.
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Wearing a bandage is contraindicated in patients with internal organ occupies a displaced position due to the presence of adhesions in the surrounding tissues.
Physical therapy exercises
A course of special exercise therapy provides a positive effect of therapy for nephroptosis. At the initial stage, the exercises are performed under the supervision of a specialist; subsequently, the physical warm-up complex can be continued independently.
Together with therapeutic exercises, the patient should adhere to a gentle salt-free diet, and also limit any physical activity.
Surgery
With absence positive results conservative treatment, as well as for nephroptosis stages 2 and 3 is indicated surgery- nephropexy (kidney fixation). The operation is performed using laparoscopy, during which the displaced organ is attached to the connective tissues.
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Introduction
Nephroptosis, or omission kidneys, – a condition in which the mobility of the kidney exceeds physiological norm. Normally, when changing body position and breathing, the kidney can move from the renal bed in the vertical direction up to 2 cm. With nephroptosis, the kidney can move up to 10 cm. Sometimes it can descend into the small pelvis. Such a mobile bud is also called "wandering" kidney .
The kidney is held at the physiological level by ligaments, fascia that form the renal bed, intra-abdominal pressure (created by the muscles of the anterior abdominal wall and the diaphragm), the fascial-fatty capsule of the kidney and the fatty tissue between the adrenal gland and the kidney.
According to statistics, nephroptosis is currently observed in 1.5% of women and 0.1% of men. The predominant age for this pathology is 25-40 years. Nephroptosis is observed predominantly on the right. This is explained by the fact that the left kidney has a stronger ligamentous apparatus and the fact that the right kidney is normally located lower than the left. In some cases, bilateral prolapse is noted ( ptosis) kidney.
Causes of kidney prolapse
There are many reasons for the development of nephroptosis. The most common of them:- significant and rapid decline weight may lead to a decrease in the volume of the fatty capsule of the kidneys;
- hereditary predisposition to increased extensibility of connective tissue (Ehlers-Danlos syndrome);
- trauma to the lumbar region with damage to the ligamentous apparatus and the formation of a hematoma in the perinephric tissue;
- heavy physical activity and work with heavy lifting;
- infectious kidney diseases;
- excessive stretching of the muscles of the anterior abdominal wall during pregnancy.
Stages of nephroptosis
There are 3 stages of development of nephroptosis:- at stage 1 the drooping kidney is palpated during inspiration through the abdominal wall, and during exhalation the kidney again goes under the costal edge and cannot be palpated;
- at stage 2 nephroptosis, the kidney can be completely palpated below the hypochondrium when the patient is in an upright position, but in a supine position it goes back into the hypochondrium;
- at stage 3 the kidney completely (regardless of the position of the body) comes out of the hypochondrium and can even move into the pelvis.
Such vascular changes lead to impaired blood supply to the kidney tissue: hypoxia and increased venous pressure, impaired lymphatic drainage. Changes in hemo- and lymphodynamics create conditions for the development of chronic pyelonephritis (inflammation of the pelvis and kidney tissue).
In stage 3 nephroptosis, the ureter may be kinked, which will lead to impaired urine outflow and dilation of the renal pelvis. An inflammatory and then adhesive process can occur around the kidney (perinephritis). These adhesions will fix the kidney in a pathological position. As nephroptosis develops with disturbances in hemodynamics and urine outflow, clinical manifestations of nephroptosis appear.
Symptoms of kidney prolapse
Clinical manifestations of nephroptosis depend on its stage. At the onset of the disease, symptoms may be mild or absent altogether. You may be bothered by intermittent dull pain in the lumbar region on the side of the prolapsed kidney. In stage 1, pain appears occasionally, usually after a strong cough or physical activity. Lying on the affected side or back, the pain disappears. As the prolapse of the kidney increases, the intensity and frequency of pain increases; diffuse abdominal pain may appear, radiating to the back. In stage II nephroptosis, protein and red blood cells appear in the urine due to hemodynamic disturbances in the kidney.
At Stage III The pain is constant and does not disappear in a horizontal position. This may reduce the patient's ability to work. Attacks of renal colic are also possible, when the pain becomes unbearable and may be accompanied by nausea and vomiting.
At stage III of nephroptosis, there is a deterioration in appetite, impaired intestinal function, and signs of depression appear. The progression of the disease leads to the appearance of signs of pyelonephritis, increased blood pressure, and hydronephrosis may form (persistent, progressive expansion of the renal collecting system due to impaired urine outflow).
Promotion blood pressure initially observed only in the upright position of the patient (orthostatic hypertension). In some patients, fornical bleeding (bleeding that occurs during exercise) or symptoms of pyelonephritis are the first manifestations of nephroptosis.
Why is nephroptosis dangerous?
Nephroptosis can cause serious complications: pyelonephritis, urolithiasis, hydronephrosis. Nephroptosis itself may not have any manifestations, but the pathological process of structural damage to the kidney tissue has already begun.- Impaired urine flow contributes to the development infectious process and the formation of calculi (stones) in the renal pelvis.
- A wandering kidney can cause spontaneous abortion.
- As the process progresses, nephroptosis will cause an increase in blood pressure, which also has a very serious complications(stroke and myocardial infarction).
Diagnosis of nephroptosis
The following methods are used to diagnose nephroptosis: - interviewing the patient about complaints, past illnesses and injuries;
- examination of the patient with palpation (palpation) of the abdomen;
- X-ray examination ( excretory urography and plain radiograph of the kidneys);
- Ultrasound of the kidneys (lying and standing);
- scintigraphy or radioisotope scanning clarifies the position of the kidneys;
- renography allows you to clarify the state of kidney function;
- laboratory analysis of blood and urine allows us to identify and clarify the presence of complications of nephroptosis.
Nephroptosis during pregnancy
In women, nephroptosis develops at 10 p.m. more often than among representatives of the stronger half of humanity. This is due to the peculiarities of the anatomical structure female body: the renal bed in women is wider and lower, the fatty capsule of the kidney in women is wider and shorter, the connective tissue of the ligamentous apparatus is more extensible, and the abdominal muscles are less developed than in men.Abdominal pain increases with physical activity and decreases when lying down. In this case, nausea and loose stools may occur. Urinary syndrome is manifested by the appearance of red blood cells, white blood cells, protein and bacteria in the urine. Dysuric syndrome is manifested by urinary incontinence (at night and during the day).
Prevention of nephroptosis in childhood lies in the right physical education child, eliminating unbearable stress (including psycho-emotional), ensuring rational nutrition and prevention of childhood injuries.
Treatment of nephroptosis (prolapse of the kidney)
For nephroptosis, conservative and surgical treatment is used.Conservative treatment
Conservative treatment is carried out in the absence of complications. Conservative treatment includes: orthopedic treatment, abdominal massage, physiotherapy, Spa treatment and diet.Drug therapy is used only for the treatment of complications of nephroptosis (pyelonephritis, urolithiasis, arterial hypertension).
Sodium causes fluid retention in the body, which contributes to edema and increased blood pressure. Therefore, the use table salt should also be limited.
Orthopedic treatment (bandage)
Wearing a bandage is very useful for nephroptosis. You should put on a bandage (or an orthopedic belt, or a corset) in the morning, while still lying in bed. Orthopedic bandage It should only be worn while exhaling, otherwise wearing it will be useless. The bandage should be removed in the evening before going to bed.
Currently, there is a large selection of corsets, bandages, and orthopedic belts. Before purchasing any of them, you should consult a doctor, as there are a number of contraindications for their use. One of the contraindications is “fixed nephroptosis”.
Exercise therapy
Physical therapy and abdominal massage have an effect only in stage 1 of nephroptosis. Fulfill therapeutic exercises should be done daily in the morning for 30 minutes. The exercises are performed while lying on your back. You can place a small cushion under your lower back.
1.
The legs are slightly bent at the knees. Make 5-10 breathing movements with the participation of the diaphragm: when inhaling, stick your stomach out as much as possible, and when exhaling, pull it in as much as possible.
2.
5-8 rub. raise your straight legs alternately.
3.
6-8 rub. pull each leg bent at the knee towards your stomach.
4.
Perform the “bicycle” exercise for 1-2 minutes.
5.
Squeeze a small ball between your knees for 6-8 seconds. Repeat the exercise 4-5 times.
6.
5-10 rub. Raise both extended legs up as you inhale, and lower as you exhale.
7.
Raise your legs straight up, knees and heels together. As you inhale, spread your legs apart, and as you exhale, cross your legs. Repeat the exercise 5-6 times.
Allowed for kidney prolapse sedentary games and walks on flat terrain. Jumping, hanging, stretching and running are prohibited.
Spa treatment
For stage I nephroptosis, sanatorium-resort treatment is widely used, especially with the use of hydrotherapy - swimming, baths, drinking mineral water.
This treatment can be carried out in local sanatoriums, as well as in resorts in the Caucasus Mineralnye Vody(Kislovodsk, Pyatigorsk, Essentuki, Zheleznovodsk) and in Truskavets (Ukraine).
Surgical treatment
Surgical treatment is performed if there is no effect from conservative treatment and development severe complications nephroptosis. Indications for surgical treatment: persistent pain, disability, chronic recurrent pyelonephritis, increased blood pressure (orthostatic hypertension), hydronephrosis.Purpose surgical intervention is fixation of the kidney (nephropexy) in its anatomical bed for a long time.
Currently, this operation is performed primarily by laparoscopy. It has a number of advantages: there is a lower risk of complications, the method is less traumatic, there is virtually no blood loss, and the patient’s recovery after surgery is easier.
Treatment with folk remedies
Traditional medicine recommendations can be used in the initial stages of nephroptosis along with conservative treatment. They help prevent complications, reduce the intensity of pain, but return the prolapsed kidney to its normal position traditional methods impossible. Recipes for preparing folk remedies:
1.
It is recommended to eat sunflower seeds, pumpkin seeds, flax seeds, and any nuts. Flax seeds can be irrigated with drinking water, sprinkled with powdered sugar and fried in a dry frying pan. Take 3-4 r. per day 1 tsp. (chewing thoroughly).
2.
Take 2 tbsp. chopped stems of broom kochia, pour 300 ml of boiling water, leave for 12 hours, strain. Take 5 ml 3 times between meals. in a day.
Nephroptosis (prolapse of the kidney): causes, symptoms, methods of diagnosis and treatment - video
Treatment of nephroptosis (bandage, laparoscopy) - video
Do people with nephroptosis get drafted into the army?
Examination of citizens during military registration and conscription for military service (including under contract) is carried out in accordance with the document “Schedule of Diseases”.Nephroptosis in the Schedule of Diseases is classified according to Article 72. The suitability category is determined depending on the degree of nephroptosis.
Conscripts with 1st degree nephroptosis are classified according to Article 72, paragraph “G” - fit for military service.
Examined with stage II nephroptosis. and with secondary pyelonephritis are classified according to Article 72, paragraph “B” and are exempt from military service, they are included in the reserve.
Examination for kidney diseases is carried out on the basis of inpatient examination and treatment.
A wandering kidney is a pathology of the urinary system, which is characterized by excessive movement of the renal organ outside the anatomical bed.
Due to high mobility, the kidney can drop significantly downwards, reaching the pelvic area.
A mobile kidney is more characteristic of women due to the peculiarities of the anatomical structure of the body. Elderly people are also susceptible to this pathology.
Causes
Both renal organs are naturally mobile, but their normal deviation from their usual place is no more than 1-2 cm.
If the displacement of the kidney exceeds this figure, doctors diagnose a pathology such as nephroptosis, a type of which is a wandering kidney.
Since the left kidney is located higher than the right, the mobility of the latter is slightly higher, so it is the right kidney that is more often diagnosed as wandering.
Doctors currently cannot say with absolute certainty what specific causes provoke this pathology.
However, along with this, certain factors are identified that favor the occurrence of pathological movements of the organ.
First of all, the kidney may become wandering due to weakening of the abdominal muscles, loss of elasticity of the fascia, or excessive depletion of the fat capsule.
Abdominal muscles can lose strength due to various circumstances. In particular, even heavy labor activity, multiple pregnancy favors relaxation of the abdominal wall.
The kidney capsule becomes depleted if the body loses excess weight too quickly. This situation happens when a person subjects himself to a strict diet or suffers a serious illness in the near future.
The kidney can also become wandering if the fascia has been torn; accordingly, nothing can hold the organ in one anatomical position.
Most often this happens when a person gets into dangerous situations resulting in serious injury.
Favors increased organ mobility difficult conditions labor when you have to move or lift heavy objects.
Even coughing, intestinal constipation can trigger the appearance of a wandering kidney.
In rare cases, doctors consider such a pathology as pathological heredity, when the structure of the connective tissue undergoes serious changes.
Symptoms
If the kidney has become wandering, and its deviation from the natural bed is great, the patient will definitely notice this, since the pathology in this case is accompanied by certain symptoms.
Unfortunately, stage 1 nephroptosis is quite difficult to recognize and visually diagnose, since there are no obvious symptoms, the person simply does not worry about anything.
It is most often possible to identify a grade 1 vagus organ only by chance, when a person is sent for ultrasound diagnostics for other reasons.
However, each person is unique, so the body can perceive individual internal pathological processes differently.
As a result, a wandering kidney can be suspected based on the individual symptoms that appear. In particular, pain in the lumbar region indicates renal pathologies.
If painful sensations eliminated after a change in body position, it is quite possible that the organ has become excessively mobile and wandering. It is no secret that a wandering kidney can be returned to the renal bed, indeed occupying a horizontal position.
Symptoms of a wandering kidney can also include increased heart rate, as well as excessive increases in blood pressure.
In some cases, the vagus organ manages to affect the nerve endings, squeezing them, resulting in neuralgia, excessive irritability and hot temper.
Nephroptosis is also characterized by loss of appetite and intestinal disorders.
In addition, the patient feels a clear loss of strength, dizziness, and often experiences insomnia.
Complications
If you notice signs of a wandering kidney, it is important to immediately seek medical help.
Ignoring the symptoms of a wandering kidney can lead to disastrous results, since excessive mobility of the kidney can provoke some pathologies that are accompanied by serious danger.
In particular, the kidney in the process of movement can affect the ureter, causing its compression. In such cases, natural urination is disrupted.
Urine begins to accumulate in the kidney, negatively affecting its condition. Urine favors the development of pathogenic bacteria, so it increased concentration provokes infectious and inflammatory processes.
Also, a high concentration of urine provokes urolithiasis, which occurs due to the combination of grains of sand into stones, and subsequently into large conglomerates.
Urinary dysfunction contributes to the occurrence of such the most dangerous disease like hydronephrosis.
Pyelonephritis may occur, followed by frequent attacks renal colic.
When reducing diameter renal artery, which happens when it is compressed or twisted, the patient begins to suffer from increased blood pressure, which is certainly followed by headaches.
The dangerous thing is that due to oxygen deficiency, hypertensive crises can occur.
The most serious and dangerous not only for health, but also for life, is renal failure, which can also act as complications if there is inaction and complete ignorance of the signs of a wandering kidney.
Diagnostics
Identifying a wandering kidney helps not only the symptoms that the patient is ready to list at a doctor’s appointment, but also a visual examination with simultaneous palpation.
An experienced doctor can immediately identify a wandering kidney, but to clarify the diagnosis, he will still refer the patient for laboratory and instrumental diagnostics.
Measuring blood pressure in different positions can also identify the wandering kidney. In particular, blood pressure readings in horizontal and vertical positions may differ by 15–30 mm. Hg
When conducting laboratory research urine is determined by the presence of red blood cells, leukocytes, and protein in it.
Doctors do not stop at the results obtained laboratory diagnostics, be sure to refer the patient for instrumental examination.
Ultrasound examination can identify the wandering kidney. During the diagnostic process, the location to which the renal organ is moved is determined.
Ultrasound diagnostics for this purpose are carried out only after the patient has been in an upright position for some time, and accompanied his actions with additional activity.
The wandering bud makes it possible to detect and X-ray examination, excretory urography, for which a special contrast agent is injected into a vein.
Angiography allows not only to detect kidney prolapse, but also to pay attention to the condition of the veins.
Radioisotope scanning and scintigraphy are also used as instrumental diagnostics.
Treatment
If the symptoms confirm a pathology such as nephroptosis, the doctor considers several treatment options.
Conservative techniques and surgical intervention can be used. The technique is selected depending on the degree of pathology detected in the patient.
At the initial stage of development of the wandering kidney, the doctor establishes only medical control, which provides for constant monitoring of the condition of not only the patient, but also the dynamics of the pathology.
If you put on a bandage in a vertical position, you can fix the organ in the wrong position, adhesions will strengthen Negative consequences incorrect fixation.
Sanatorium-resort treatment is accompanied by high effectiveness.
Modern medicine successfully performs nephropexy, which makes it possible to artificially create conditions that support the kidney in the right place.
Nephropexy is performed laparoscopically, accompanied by minimal trauma.
Abdominal surgery in last time is carried out extremely rarely, when there is no other option surgical intervention No.
So, nephroptosis poses some threat to the health of every person, but timely treatment can prevent any complications.
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