Hydronephrosis

Definition

• Hydronephrosis is a condition where one or both kidneys swell due to the accumulation of urine.

Causes

• Ureteropelvic junction obstruction (UPJO)
• Ureterovesical junction obstruction (UVJO)
• Congenital anomalies
• Infections
• Tumors
• Trauma
• Benign prostatic hyperplasia (BPH)

Pathology and Progression

• The renal pelvis and calyces become distended with urine.
• The renal parenchyma compresses and atrophies.
• Chronic obstruction can lead to permanent damage and scarring.

Clinical Features

• Abdominal pain
• Nausea and vomiting
• Hematuria
• Pyelonephritis
• Chronic kidney disease

Diagnostic Approach using Imaging

• Ultrasonography
• Computed tomography (CT) scan
• Intravenous pyelography (IVP)
• Magnetic resonance imaging (MRI)

Management Strategies

• Conservative management
• Ureteral stenting
• Nephrostomy tube placement
• Pyeloplasty
• Ureteral reimplantation
• Nephrectomy

Types of Hydronephrosis

• Acute hydronephrosis
• Chronic hydronephrosis
• Recurrent hydronephrosis

Pathophysiology

• The kidney's ability to concentrate urine is compromised.
• The renal pelvis and calyces become distended.
• The renal parenchyma compresses and atrophies.

Complications

• Chronic kidney disease
• Pyelonephritis
• Urosepsis
• Renal failure

Treatment

• Conservative management: bed rest, analgesics, and hydration.
• Ureteral stenting: to relieve obstruction.
• Nephrostomy tube placement: to drain the kidney.
• Pyeloplasty: surgical repair of the ureteropelvic junction.
• Ureteral reimplantation: surgical repair of the ureterovesical junction.
• Nephrectomy: surgical removal of the kidney.

Homoeopathic Therapeutic Medicines

• Lycopodium: for renal colic and hydronephrosis.
• Berberis: for renal colic and urolithiasis.
• Cantharis: for urinary retention and hydronephrosis.
• Apis: for renal inflammation and hydronephrosis.
• Pulsatilla: for renal colic and hydronephrosis.

Blood Supply

• The blood supply to the kidney is primarily through the renal arteries.
• The renal arteries arise from the abdominal aorta.
• The renal arteries divide into segmental arteries.

Nerve Supply

• The nerve supply to the kidney is primarily through the renal plexus.
• The renal plexus is a network of nerves that surrounds the kidney.
• The renal plexus receives input from the sympathetic and parasympathetic nervous systems.

Clinical Anatomy

• The kidney is located in the retroperitoneal space.
• The kidney is surrounded by the renal fascia.
• The renal fascia is a fibrous layer that surrounds the kidney.
• The renal fascia is continuous with the peritoneum.