hydronephrosis

Introduction

Dilation of the renal pelvis & calices, & sometimes, collecting ducts.

Etiology

• obstruction of urine flow by
  • urinary calculi
  • tumors
  • neurologic disorders
  • congenital anomalies
• pregnancy (may be normal finding)

Pathology

• obstruction of urine flow (obstructive uropathy)
• vesicoureteral reflux
• dilation of the renal pelvis & calices, & sometimes, collecting ducts

Clinical manifestations

• may be asymptomatic
• symptoms related to obstructive uropathy

Laboratory

• urinalyis, 24 hour urine protein if indicated
• serum creatinine

Diagnostic procedures

• post void residual

Radiology

• CT of abdomen
• abdominal US
  • anechoic regions on ultrasound can be connected by movement of the probe
• diuretic renogram: obstruction slows washout of radionuclide (0.5 mg/kg of furosemide prior to radionuclide renal scan)

Differential diagnosis

• polycystic kidney disease
  • anechoic regions on ultrasound can not be connected by movement of the probe

Management

• consider surgery in a patient with pain & a positive diuretic renogram
• no treatment is necessary in an asymptomatic patient

More general terms

• kidney disease; renal disease
• sign/symptom

Additional terms

• postrenal azotemia; obstructive uropathy
• vesicoureteral reflux