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Hydronephrosis Updated 3/2011

Pang-Yen Fan, MD
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BASICS

  • Description
  • Epidemiology
  • Pathophysiology
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Tests

TREATMENT

  • Additional Treatment
  • Surgery
  • In-patient Considerations

Ongoing Care

  • Prognosis
  • Complications
The following is an excerpt....
BASICS
Description
  • Hydronephrosis refers a structural finding—dilatation of the calyces and renal pelvis:
    • May occur with urinary tract obstruction, vesicoureteric reflux (VUR), high urine output, or physiologic changes in pregnancy
    • Sometimes accompanied with hydroureter
    • Presentation varies from incidental finding to severe pain.
  • Hydronephrosis should not be used interchangeably with obstructive uropathy, which refers to the damage to renal parenchyma resulting from urinary tract obstruction.
Epidemiology
  • Hydronephrosis is found in 3% of autopsy specimens.
  • Acute unilateral obstruction is more common than bilateral.
Pathophysiology
  • Hydronephrosis develops with increased pressure in the urinary collecting system.
  • Increased pressure within the renal collecting system can cause calyceal fornix rupture and urinary extravasation.
  • Over time, pressures return to normal, but kidney function declines from intense ...

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