Hydronephrosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
Common complications of hydronephrosis include infections, hyperkalemia, metabolic acidosis, and distal renal tubular acidosis, hypertension and renal failure.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of hydronephrosis can usually develop at any age depending on the underlying cause and present with symptoms such as, flank pain/abdominal pain, nausea, vomiting, burning and painful micturition, incomplete voiding.[1]
- If left untreated for several weeks, the kidneys may become scarred, leading to kidney failure.
Complications
Common complications of hydronephrosis include:[2][3][4][5][6]
- Infection secondary to obstruction
- Electrolyte imbalance
- Hyperkalemia
- Metabolic acidosis
- Distal renal tubular acidosis
- Excessive free water diuresis
- Hypertension
- Renal insufficiency and renal failure
Prognosis
- Prognosis is generally good with early treatment. Approximately 95% patients recover with timely intervention.[7][8]
References
- ↑ Sarhan OM, El Helaly A, Al Otay AH, Al Ghanbar M, Nakshabandi Z (March 2018). "Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history?". Can Urol Assoc J. 12 (3): E137–E141. doi:10.5489/cuaj.4587. PMC 5869039. PMID 29283090.
- ↑ Kozeny GA, Hurley RM, Vertuno LL, Bansal VK, Zeller WP, Hano JE (1986). "Hypertension, mineralocorticoid-resistant hyperkalemia, and hyperchloremic acidosis in an infant with obstructive uropathy". Am. J. Nephrol. 6 (6): 476–81. doi:10.1159/000167258. PMID 3565506.
- ↑ Chandar J, Abitbol C, Zilleruelo G, Gosalbez R, Montané B, Strauss J (February 1996). "Renal tubular abnormalities in infants with hydronephrosis". J. Urol. 155 (2): 660–3. PMID 8558697.
- ↑ Lee JH, Choi HS, Kim JK, Won HS, Kim KS, Moon DH, Cho KS, Park YS (April 2008). "Nonrefluxing neonatal hydronephrosis and the risk of urinary tract infection". J. Urol. 179 (4): 1524–8. doi:10.1016/j.juro.2007.11.090. PMID 18295269.
- ↑ King LR, Kazmi SO, Belman AB (October 1974). "Natural history of vesicoureteral reflux. Outcome of a trial of nonoperative therapy". Urol. Clin. North Am. 1 (3): 441–55. PMID 4610948.
- ↑ Mesrobian HG (September 2010). "Urinary proteome analysis and the management of ureteropelvic junction obstruction". Pediatr. Nephrol. 25 (9): 1595–6. doi:10.1007/s00467-010-1521-2. PMID 20407913.
- ↑ Perlman S, Roitman L, Lotan D, Kivilevitch Z, Pode-Shakked N, Pode-Shakked B, Achiron R, Dekel B, Gilboa Y (February 2018). "Severe fetal hydronephrosis: the added value of associated congenital anomalies of the kidneys and urinary tract (CAKUT) in the prediction of postnatal outcome". Prenat. Diagn. 38 (3): 179–183. doi:10.1002/pd.5206. PMID 29314159.
- ↑ Renda R (April 2018). "Renal outcome of congenital anomalies of the kidney and urinary tract system: a single-center retrospective study". Minerva Urol Nefrol. 70 (2): 218–225. doi:10.23736/S0393-2249.17.03034-X. PMID 29161808.