Symptoms and treatment of kidney prolapse. Wandering kidney symptoms in women Kidney prolapse symptoms causes and consequences

Healthy kidneys are located on the right and left sides of the spine on the border of its thoracic and lumbar regions. Normally, they only slightly protrude from under the ribs, and the amplitude of their movement during breathing, coughing and physical exertion does not exceed 1-1.5 cm. , and they acquire the ability to move freely in the retroperitoneal space. What are the causes, features of the course, symptoms and treatment of this condition: let's understand.

Pathological mobility of the kidneys in medicine is called nephroptosis (in Latin - nephroptosis). So, for example, when the urinary organ is lowered and kept in a fixed position, fixed nephroptosis develops. A pathology in which, in addition to moving along the vertical axis, the kidney is freely displaced from side to side, is called the wandering kidney.

The reasons

Due to the anatomical features of the structure of the urinary system, women are more prone to the disease than men. Approximately 80% of cases develop right-sided nephroptosis.

Possible reasons for the formation of a wandering kidney can be:

• too rapid weight loss during fasting, following a strict diet, stress;
• genetic diseases accompanied by a violation of the structure of muscle and connective tissue fibers;
• weight lifting, excessive physical activity;
• back and abdomen injuries;
• frequent pregnancies and childbirth;
• muscle atony in various neurological diseases, in old age;
• rachiocampsis.

An important pathogenetic aspect of the disease is the weakness of the anatomical structures that support the kidneys in a physiological position:

• fatty and connective tissue (fibrous) capsules;
• renal bed formed by the lateral lateral, psoas major and square psoas muscles;
• powerful vascular network;
• action of intra-abdominal pressure.

Clinical manifestations

The course of nephroptosis is usually chronic. At the initial stages, the mobile kidney does not manifest itself in any way, although pathological movements along the vertical and horizontal axes have already begun. A little later, the following signs of the disease join:

• Pain in the projection of the wandering kidney. It can be localized at the level of the hypochondrium or in the iliac region, often migrates. The nature of painful sensations is dull, aching.
• Manifestations of an infectious lesion of the renal pelvis, bladder, ureters: burning, cramps during urination, change in color and smell of urine, the appearance of a cloudy sediment in it, sometimes hematuria.
• Hemodynamic disorders: sharp jumps in blood pressure, tachycardia.
• Neurological symptoms: neuralgia of regional branches, weakness, fatigue, asthenic syndrome phenomena, personality changes (irritability, anxiety, signs of hypochondria), sleep disturbances.
• Digestive disorders: decrease / complete lack of appetite, heaviness in the abdomen, flatulence, stool instability.

Depending on how increased the mobility of the kidney, there are three degrees of the disease:

1. at the first, the affected organ comes out by a third from under the edge of the costal arch and is easily palpable;
2. the second degree is characterized by the complete exit of the kidney from under the hypochondrium: it is well palpated if the patient is standing, but returns to its original position in a horizontal position;
3. the exit of the urinary organ from the hypochondrium - it moves freely in the retroperitoneal space.

Wandering kidney is a health hazard. In the absence of timely treatment, it causes bending, twisting and other changes in the supply vessels and the ureter. These factors cause the development of complications:

• pyeloectasia and hydronephrosis;
• urostasis;
• infectious and inflammatory processes, chronic pyelonephritis;
• chronic renal failure.

Principles of diagnosis and treatment

It is possible to diagnose the disease at an early stage only on the basis of instrumental methods - ultrasound, excretory urography, angiography of the renal vessels, scintigraphy. A significant omission of the kidney is easily determined by the characteristic clinical picture and the data of an objective study.

The disease can be treated in several ways. The etiological method - surgical fixation of the vagus kidney - is carried out at the 3rd degree of nephroptosis to normalize the functioning of the organ and prevent possible complications. Major abdominal surgery is now rare, and minimally invasive laparoscopic techniques are preferred.

It is possible to reduce the increased mobility of the urinary organ by conservative methods. All patients are advised to follow a diet with a restriction of fatty fried foods and heavy protein foods, an adequate diet, exercise exercise. Fixation of the wandering kidney is carried out using an individually selected corset or bandage.

Symptomatic therapy includes the appointment of:

• antibiotics (when infection is attached);
• diuretic drugs;
• plant uroseptics;
• anti-inflammatory drugs;
• antispasmodics;
• analgesics.

Nephroptosis is a disease with poor clinical symptoms that can lead to serious consequences. Timely diagnosis and reliable fixation of the vagus kidney will allow maintaining normal urodynamics and avoiding the development of complications.

pochkizdrav.ru

Causes of kidney prolapse

There are various causes, as well as stages of kidney prolapse. Before starting treatment, make sure that your symptoms match. So, the symptoms that cause prolapse of the kidney:

• unexpected weight loss;
• lumbar injury with the occurrence of hematoma in the kidney area;
• heavy physical labor, consisting in lifting weights (especially for women);
• infectious diseases of the kidneys.

Symptoms of prolapse of the kidneys in women appear more often than in men, and, accordingly, more serious consequences. The reasons lie in the more elastic connective tissue, as well as weak abdominal muscles.

Types of kidney prolapse

There are various degrees and stages of kidney prolapse. Depending on the degree of kidney mobility, it is necessary to distinguish:

• fixing;
• mobile view of a lowered kidney (this pathology is also called a wandering kidney).

There are three stages in the development of the fixing type. Their symptoms are:

• symptoms of the first stage - the lower part of the kidney during inspiration comes out of the hypochondrium, and when exhaling it returns to its original position. Such a movement occurs when a person's body suddenly changes from horizontal to vertical. Treatment in this case will be the most effective;
• symptoms of the second stage - the kidney is shifted to the pelvic region. As a result of increased pressure in the renal vessels, protein and red blood cells are present in the urine. This period is quite painful, the patient may have symptoms such as colic and aching dull pain. In this case, treatment should be started immediately, as the consequences can be very negative;
• symptoms of the third stage - stretching of the renal pedicle and its further twisting. The consequences can manifest themselves in the form of difficult urine excretion and the occurrence of infectious complications.

Symptoms of a drooping kidney

Symptoms of kidney prolapse directly depend on the degree of neglect of the process. In the first degree, a person may be unaware that treatment is needed. The initial stages are not always accompanied by painful processes and changes in the biochemical parameters of the blood. In some cases, the causes of this phenomenon can provoke pain in the lumbar region, which quickly passes. If pain occurs rarely, it is difficult to find its cause and prescribe appropriate treatment.

At the beginning of the second degree of prolapse, there are aching constant pains that become quite strong, they deprive a person of his ability to work, lead to loss of appetite and a depressive state.

Dangers of kidney prolapse

If appropriate treatment is not prescribed, especially with the last degree of kidney prolapse, this can lead to the following consequences:

• lack of treatment leads to hydronephrosis, pyelonephritis and urolithiasis. In this case, no special symptoms may be observed, but the process will already be started, and over time it will be too late to do anything;
• a mobile kidney can cause causes of abortion - miscarriage;
• disability;
• stroke and hypertension.

Treatment of kidney prolapse

What to do after you have determined the causes and degrees of kidney prolapse? Of course, start timely treatment, and you can choose what to do: use folk or traditional methods.

Treatment consists in the absence of shaking, heavy physical exertion, jumping. What can be done to ease the burden on the kidneys? Reduce the amount of meat and salt consumed, you can follow a special diet for the kidneys, which should be prescribed by a doctor.

If there are no indications for surgical intervention, then the kidney can be fixed, in which case it is recommended to use a special lumbar bondage. It is recommended to put it on only in a supine position, tightening it while inhaling, otherwise the reasons for non-compliance with the rules can lead to a worsening of the condition. If the patient has a lack of weight, then it is necessary to adhere to a special diet. An increase in the volume of the fat layer will allow you to quickly cope with the disease.

You can use various painkillers, antispasmodics, take warm baths and sleep in a position with slightly elevated legs. One of the most important elements of the treatment of such a disease is LKF. Such an exercise will allow you to fix the kidney in one position, excluding the possibility of its further omission.

If the descent of the kidney happened below the 4th lumbar vertebra, then surgical intervention is necessary. Also indications for surgery may be severe pain, irreversible disorders of the kidney and increased blood pressure of the renal breed.

Folk methods of treatment

Alternative methods will be effective only if there is no need for surgical intervention. Such methods can be an excellent prevention of complications, reducing pain symptoms, but they will not be able to return the lowered kidney to its previous state. So, here are some of the most effective recipes for treating a drooping kidney at home:

• sunflower, pumpkin, flax and any nuts can benefit. Flaxseeds should be washed with drinking clean water, sprinkled with powdered sugar and roasted in a dry frying pan. Take orally three times a day, a teaspoon, chewing well;
• chop the stalks of broom kochia and pour boiling water in a ratio of 1: 3. The resulting mixture should be brewed for about 12 hours, after which it should be carefully filtered. Drink the resulting liquid three times a day for a quarter of a tablespoon;
• now we turn to the adoption of healing baths. Cut oats and straw mixing with water in a ratio of 1:20. The resulting mixture should be boiled over low heat for about an hour, then let it brew for several hours. The resulting solution should be used in its pure form for taking a bath;
• a mixture of flax seeds, echinacea flowers, rosehip petals, knotweed pour boiling water and leave for about 15 minutes. Take three times a day for one month.

Physical exercises with kidney prolapse

The basis of the cure for nephroptosis is special gymnastics. There are a number of specific exercises that should be done at least once a day. The proposed complex allows you to strengthen the muscles of the lower back and abdomen, while stabilizing the position of the kidney in the peritoneum.

• "martin". Starting position, lying on your stomach, legs together, straightened, arms spread out to the sides with palms down. At the same time, we tear off the arms, head, straight legs and chest from the floor as much as possible. We hold in this position for 1-3 seconds, then lower ourselves. You need to do the exercise without jerking, smoothly. It is recommended to do 10-15 repetitions. If physical fitness is weak, you can only raise your legs, arms and head. Important: the legs should not be bent at the knees;
• Starting position: lie on your back, arms along the body, palms down. We raise each leg, without bending at the knees, in turn. For each leg, repeat 10 times;
• lie on your back, pull your legs to your stomach, bending at the knees. Repeat at least 10 times. There is a simpler option - an identical exercise, but perform for each leg in turn;
• lying on the left, and then on the right side, raise the straight leg as high as possible, repeat 8–10 times;
• for the exercise you will need a small ball: in the prone position, squeeze the ball between the legs above the knees, holding it in a compressed position for 8-10 seconds. Repeat several times.

Depending on the physical fitness and state of health, you can expand the set of exercises. It must be remembered that first of all, attention should be paid to the oblique, lateral, rectus abdominis muscles and the muscle that straightens the spine. These muscles allow you to achieve a powerful frame that will protect against the omission of the kidneys, stabilizing its position.

Prevention of kidney prolapse

Sports will be an excellent prevention of kidney prolapse. Morning daily exercises, the so-called exercises, can strengthen the muscles of the whole body, helping them to better cope with heavy unexpected loads. In addition to such charging, you can also use evening or morning jogging, cycling, swimming in the pool, as well as other types of active lifestyle.

It is recommended to pay special attention to the lumbar region, since a strong press is a reliable guarantee against infringement of the spinal nerve, prolapse of the kidneys and protrusions of the intervertebral discs. A person should not be afraid of regular sports, because this will protect him from the possible omission of the kidney when lifting weights.

People who have the first stage of nephroptosis are advised to visit a nephrologist at least once a year, take urine tests and undergo an ultrasound of the kidneys. This will allow you to adjust the treatment in a timely manner, preventing the subsequent development of the disease.

wmedik.ru

general information

Let's go back to anatomy first. The kidney is one of the paired organs of the human body. It is located in the lumbar region and is held there by the abdominal ligaments, fascia, muscles of the peritoneum and the supporting ligament of the kidneys.

In a healthy person, the displacement of this organ is allowed no more than a few centimeters. This process occurs due to respiratory movements.

With a floating kidney, the organ can move down. It is worth noting that it can return to its original place, which is why it is called wandering.

With complications, it is constantly in the pelvic area. This condition entails many urological diseases, so it is very important to diagnose nephroptosis in the early stages.

Most often, this disease affects women and adolescents, less often - men.

Causes

There are many reasons for the development of nephroptosis, among them it is worth highlighting the following:

• frequent infectious diseases;
• weight loss, which leads to muscle relaxation;
• pregnancy;
• kidney injury;
• lifting or carrying heavy things;
• professional sports.

Symptoms of manifestation

Most often, nephroptosis is right-sided. It is important to note that a floating kidney usually has no characteristic symptoms.

But this is its insidiousness, since as it shifts to the abdomen, irreversible processes occur in the organs.

The most striking sign of nephroptosis is pain in the lower back from the side of the omission. As the disease progresses, the following symptoms are observed:

• short-term pain that is pulling, stabbing or aching in nature;
• lying on your back, all unpleasant symptoms disappear;
• loss of appetite;
• nausea and vomiting;
• pain sensations that are given to the organs of the reproductive system;
• increase in body temperature;
• bowel disorders in the form of frequent constipation or diarrhea;
• feeling of heaviness in the abdomen;
• dizziness;
• sleep disorders;
• increased heart rate;
• when pressing on the diseased kidney, the patient feels severe pain.

With improper treatment, serious complications develop.

Flow stages

Wandering kidney has several stages of development:

• at the initial stage, the organ can be felt in the hypochondrium;
• at this stage, the kidney can leave the anatomical zone, but if the patient lies on his back, it returns to its original place on its own;
• at the last stage, there is a shift to the pelvic area, it becomes very difficult to return the organ to its place.

At the last stage, the patient has serious complications that threaten his life.

Diagnostic Measures

When the first alarming signs of a floating kidney appear, it is recommended not to hesitate to contact a nephrologist. He will conduct a thorough examination and interview with the patient.

As instrumental methods, ultrasound examination of organs, radiography and excretory urography are carried out.

The results help to establish how much the organ has been displaced and whether other parts of the urinary system are affected. It is important to note that the diagnosis of nephroptosis is made in case of displacement of the kidney by more than 5 cm.

Therapy Methods

Depending on the stage of development of the wandering kidney, the doctor selects the correct method of treatment.

Traditional ways

In the case of nephroptosis, there are no drugs that help return it to its original place. Doctors use this type of treatment to prevent the development of complications. It can be anti-inflammatory, antibacterial, diuretic drugs.

Their appointment is carried out exclusively by a specialist after receiving the results of a comprehensive examination.

If the patient has concomitant diseases of the urinary system and needs surgical correction of the vagus kidney, then the treatment of complications is carried out first, and only then the operation is started.

One of the options for conservative therapy is the wearing of a special orthopedic bandage. It helps to fix the kidney in the desired position and prevents its further displacement.

Be sure to correct the nutrition of the patient. All fatty, spicy and fried foods are excluded from the diet, the drinking regime is regulated. If nephroptosis is caused by sudden weight loss, then a diet is selected that allows the patient to return to normal.

Surgical intervention

If the methods of conservative therapy do not bring the desired result, then the doctor decides to perform a surgical operation. In this case, the organ is attached to the right place with the help of special threads.

The main indications for such an operation are the presence of stones, pyelonephritis, frequent colic in the organ, jumps in blood pressure.

Today, thanks to the achievements of modern medicine, the operation is performed using a laparoscope. This method is considered less traumatic, and the rehabilitation period for the patient is painless. Previously, doctors performed the operation in the traditional abdominal way.

To do this, an incision about 20 cm in size was made on the patient's body, then, using a small section of muscle, the lowered organ was attached in the right place. However, this type of intervention is very painful, the rehabilitation period is about 14 days (his patient spends in strict bed rest).

It is important to note that the patient must properly prepare for such an operation, since the effectiveness of its implementation depends on this. In the presence of concomitant diseases of the organs of the urinary system, they are first treated, then they only begin the procedure for eliminating nephroptosis.

A few days before surgery, the patient is admitted to the hospital and is on bed rest. It should be noted that his legs on the bed should be in an elevated position. To prevent the risk of developing thrombosis, it is imperative to conduct tests for the level of blood clotting.

During the rehabilitation period, the patient is prescribed antibacterial, antispasmodic and anti-inflammatory drugs. Overweight people may need to wear a special corset.

ethnoscience

Unfortunately, folk remedies that can return a lowered organ to its place do not exist. However, some patients still resort to such methods. Among the most popular are:

It should be noted that such methods do not give a 100% result, it is best to use them as an addition to the main therapy.

Complications

The most common complications of nephroptosis are squeezing of the ureter and pinching of the kidney. At the same time, it significantly increases in size, the patient's body temperature rises and pain intensifies.

As a result, the patient is diagnosed with pyelonephritis, kidney stones or the appearance of neoplasms. At the first symptoms of complications, it is recommended to immediately consult a doctor.

Prevention and prognosis

When treatment is started in the early stages, the percentage of her return to her natural position increases significantly. After surgery, the prognosis is positive in 90% of cases. The patient must take into account all the recommendations of the doctor in the postoperative period.

• observe the correct posture from childhood;
• limit yourself to diets and lifting heavy things;
• lead a healthy lifestyle;
• visit a doctor regularly;
• during pregnancy, wear special supportive underwear;
• avoid possible kidney injury.

With advanced nephroptosis, the patient develops serious complications. It is very important to monitor your health and consult a doctor in time, this will greatly increase the chances of recovery.

urohelp.guru

Causes 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 norms. It can be omitted, either one kidney or two. Women are more susceptible to diseases and the 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 who have flabby abdominal muscles or their body weight is much lower than normal, pathology is much more common in comparison with people who have a standard physique, go in for sports, and are not fond of diets.

You can talk about nephroptosis if there is a shift of two or more centimeters down. A displacement of up to 1-2 cm is not considered a pathology, since mobility is normal for a healthy kidney.

Location of healthy kidneys

Let's consider human physiology according to the scheme, where exactly the kidneys are located and why they can fall. Their place is on the back wall of the abdominal cavity on the sides of the spine at the level of the first lumbar vertebrae, below the thoracic. Almost always, the right kidney is lowered by 1-1.5 cm compared to the left. 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 substance of the kidney itself;
• fat capsule - fatty 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.

Symptoms of kidney prolapse may develop:

• Due to the weak ligamentous apparatus of the kidney.
• After injuries received 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 perirenal hemangioma.
• Due to weakening of the abdominal muscles. The most common reason why muscle tone decreases is multiple or not the first pregnancy.
• With a sharp and significant decrease in the thickness of the fat capsule, which can occur after an 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 health of his mother. Kidney prolapse during pregnancy depends on the number of births and the size of the abdomen. A predisposing factor is the weakening of the fixing apparatus of the kidneys, as in pregnant women, intra-abdominal pressure decreases sharply due to weakened abdominal muscles.

Diagnosis of kidney prolapse

It is important to know that vivid clinical symptoms are present only in 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. Some patient complaints are not enough to establish an accurate diagnosis. Urinalysis, ultrasound and special research methods are required. Kidney mobility is confirmed by urography - X-ray examination of the urinary tract. Please note that urography is survey, excretory, infusion. In the first case, this is a regular x-ray, in the second and third - the same x-ray, but with a contrast agent that is injected into the patient intravenously. It is important that the doctor finds out from the patient about the presence of allergic reactions. The doctor must do a test before administering the drug. For control, a dye solution is injected into one forearm, and saline into the other.

Wandering kidney symptoms

In urology, three stages of the disease are distinguished. Regardless of the cause, kidney prolapse can manifest itself as follows:

• The first stage - there is no pain or there is a slight pulling pain in the lower back, which can be aggravated by physical exertion. 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 abdomen is already long and pronounced, which indicates the progression of nephroptosis. Urinalysis shows protein, erythrocytes. The descent is accompanied by stretching, twisting of the vascular bundle and ureter. The lumens of the renal arteries and veins are narrowed by half. Pathology is accompanied by a violation of renal hemodynamics and difficult urination.
• The third stage - all of the above symptoms are intensified. Pyelonephritis develops - inflammation of the kidney due to severe ischemia of the renal tissue, venous hypertension and edema. Urinary stasis may occur with a deformed ureter. Pathological fixation of the kidney due to adhesive processes is not excluded. The pains do not go away with a horizontal position, an emotional component joins them.

The omission of the right kidney has symptoms similar to the pathology of the left kidney, but the localization of pain, of course, is on the right side of 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 undergo treatment and does not follow the doctor's recommendations. The most common complications of vagal kidney syndrome are:

• fornic bleeding;
• orthostatic arterial hypertension;
• perinephritis;
• hydronephrosis;
• pyelonephritis.

Urologists have unsightly medical statistics. In the last stage, the omission of the right or left kidney ends with the loss of working capacity in full. It's time to think about your health, because timely treatment reduces complications to minimal cases. Do not forget that recovery depends not only on the qualifications of the attending physician, but also on how well his patient fulfills the prescriptions. Be healthy, take care of yourself!

But perhaps it is more correct to treat not the consequence, but the cause?

Nephroptosis (wandering or mobile kidney) is a condition in which the kidney from its usual position (in the lumbar region) is strongly displaced to the bottom (in the abdomen and even the pelvis). At the same time, she can both return to her usual place and not return there.

The prevalence of nephroptosis

Nephroptosis occurs predominantly in women (0.1% in men and 1.5% in women). This fact is explained by the peculiarities of the structure of the female body - a wider pelvis, reduced tone of the abdominal wall, greater elasticity of the ligaments.

The kidneys, like most organs of the human body, are in relative mobility, although they have their own clear place in the body. At the moment of inhalation, the kidney moves down by 2-4 cm, with a deep breath it leaves by 4-6 cm. It reacts to the movements and movements of the body. Such physiological fluctuations help normal urine output.

But it happens that the organ gets out of control, the ligamentous apparatus does not hold the kidney, and its movements become unpredictable. It begins to wander around the body, it can move up and down, turn around a vertical or horizontal axis, move in the opposite direction. As a rule, then she returns to her place on her own, but not for long. With a long stay in some other place, the kidney can be fixed there forever by an adhesive process.

Symptoms of nephroptosis

The disease at first does not manifest itself at all, and the wandering kidney begins to declare itself with unpleasant sensations in the lumbar region on the side of the descent: more often on the right - in 75% of cases, in 10% - on the left and in 15% - on both sides. The most common consequence of kidney displacement is pain of a pulling, aching nature, less often stabbing. At the beginning of the disease, the pain is not pronounced, quickly disappear. But over the years they become more intense, constant, exhausting.

First, the pain occurs after some physical exertion, heavy lifting, intense coughing, or at the end of the working day. They decrease in the position on the back or on the sore side.

Pain at nephroptosis are also very intense - like renal colic. They can appear suddenly after strong tension or a change in body position from lying to upright and last from several minutes to several hours - then weakening, then growing. Pain often radiates to the groin, to the genitals. Sometimes this attack is accompanied by nausea and vomiting. The patient is pale, covered with a cold sweat, the temperature may rise.

Pain is not the only symptom nephroptosis. For many, a mobile kidney is manifested by loss of appetite, nausea, a feeling of heaviness in the epigastric region, constipation, or, conversely, diarrhea.

In the future, functional disorders of the nervous system are possible in the form of increased excitability, neurasthenia. Such patients are excessively irritable, distrustful of the doctor's conclusions and advice, and suspicious. They get tired easily, suffer from dizziness, palpitations, insomnia.

In the development of nephroptosis, three stages are distinguished, depending on the level of kidney prolapse:

• 1 stage. At this stage, the lowered kidney can be palpated through the anterior abdominal wall while inhaling, while exhaling, the kidney goes into the hypochondrium (normally, the kidney can only be palpated in very thin people, in everyone else it is not palpable).
• 2 stage. In the vertical position of the patient, the entire kidney already leaves the hypochondrium, but in the supine position it returns to the hypochondrium, or it can be painlessly set by hand.
• 3 stage. The kidney completely leaves the hypochondrium in any position of the body and can move into the small pelvis.

Causes of nephroptosis

The causes of nephroptosis are factors that lead to changes in the ligamentous apparatus of the kidney (infectious diseases, sudden weight loss) and to a decrease in the tone of the muscles of the anterior abdominal wall (for example, during pregnancy), as well as injuries accompanied by overstretching or rupture of the ligamentous apparatus of the kidney (sudden lifting of weights, falling from a height, etc.).

Complications with nephroptosis

At the moment of significant displacement of the kidney, more often downwards, the ureter bends, twists, the passage of urine becomes difficult. There is urinary retention, its stagnation in the pyelocaliceal system of the kidney. Urine keeps coming, but the outflow is difficult, the renal pelvis expands, which over time can lead to hydronephrotic transformation.

Most often, stagnation of urine leads to pyelonephritis - inflammation of the pyelocaliceal system of the kidneys. This is the first, earliest and most frequent complication of nephroptosis. In some cases, pyelonephritis can be acute with the development of severe pain syndrome - renal colic, which requires emergency medical care.

The renal artery is stretched, sometimes it doubles in length, naturally narrowing at the same time. As a result of torsion of the renal arteries with nephroptosis, arterial hypertension often develops, accompanied by a pronounced increase in blood pressure and poorly amenable to drug treatment. The kidney lacks blood, nutrients and oxygen, resulting in even hypertensive crises. Renal arterial pressure is the highest, especially due to diastolic figures, and can reach up to 280/160 mm Hg.

Diagnosis of nephroptosis

The diagnosis is made on the basis of complaints, examination of the patient and palpation (palpation) of the kidney, laboratory and instrumental examinations.

At nephroptosis there is a difference in blood pressure (BP) of 15-30 mm Hg. in the same patient in the vertical and horizontal position - in the vertical it increases.

A small amount of protein, leukocytes and even erythrocytes may be found in the urine test.

The main method for diagnosing nephroptosis is radiological and ultrasound examinations. The most informative instrumental methods of examining the kidneys are a survey x-ray of the urinary system, as well as excretory urography - an x-ray method of investigation, combined with the introduction of a contrast agent into the patient's vein. Pictures are taken in a standing and lying position. Radioisotope scanning and scintigraphy allow to determine the position, and renography - the functional state of the pathologically mobile kidney. Angiography allows you to judge the state of the renal artery, venography - about the venous outflow. Sometimes it is necessary to examine all organs of the gastrointestinal tract (X-ray of the stomach and intestines, FEGDS, colonoscopy) to exclude or confirm the general prolapse of the abdominal organs.

Treatment of nephroptosis

Treatment nephroptosis can be both conservative and operative.

In the early stages of the disease, in the absence of sharp pains, if complications have not yet developed, nephroptosis can be treated with conservative methods. These methods include orthopedic treatment: a special bandage in the morning, before getting out of bed, is put on a deep exhalation on the stomach, being in a horizontal position, and removed in the evening. Many different bandages, belts, corsets are offered, but they must be made individually for each specific patient. A contraindication for orthopedic treatment is only a kidney fixed in a new place by an adhesive process. In all other cases it is shown.

At the first stage of nephroptosis, spa treatment, abdominal massage, and therapeutic exercises are useful, aimed at strengthening the muscles of the abdominal press and back, ensuring normal intra-abdominal pressure and limiting the displacement of the kidneys down.

Medicines cannot put the kidney in place. However, they treat complications nephroptosis such as pyelonephritis, high blood pressure in renal arterial hypertension. Usually prescribed antispasmodic, analgesic, anti-inflammatory drugs. It is necessary to limit heavy physical exertion. If a nephroptosis developed as a result of the patient's weight loss, then sufficient nutrition is needed in order to gain the lost weight.

For the treatment of nephroptosis, a set of physical exercises aimed at strengthening the abdominal muscles is also used.

With the ineffectiveness of conservative treatment, they resort to surgical methods of fixing the kidney - nephropexy (fixing the kidney to neighboring anatomical formations). In this operation, the urologist returns the kidney to its normal bed in the lumbar region and strengthens it there.

Currently, the laparoscopic method of nephropexy has shown the greatest efficiency. (The operation is performed through abdominal punctures and the surgeon uses special manipulators and a digital camera)

The "old" abdominal operation using a muscle flap is quite traumatic and requires an extended lumbar incision of up to 20 cm. In addition, in the postoperative period, bed rest must be observed for 2 weeks so that the kidney is securely fixed in its bed.

A timely operation usually gives good results. Transient arterial hypertension, as a rule, goes away and blood pressure returns to normal.

The wandering kidney, or as it is also called nephroptosis, is a pathology of the apparatus of the urinary system, in which there is excessive mobility of the organ, manifested by a gradual downward descent.

Kidney Anatomy

The kidneys are a paired bean-shaped organ. The main function of the kidneys is to excrete harmful and toxic chemicals from the body through the formation of urine. Normally, they are located in the lumbar region on both sides. When projected onto the spine, the kidneys start from the last thoracic vertebrae (Th 11-Th 12) and extend to the first lumbar vertebrae (L 1-L 2). The right organ is slightly lower due to its location under the liver.

The kidneys are fixed in place due to several factors:

• intra-abdominal pressure;
• the presence of renal fascia;
• support by the renal bed, which consists of the psoas major and quadratus lumbar muscles;
• vascular system of the kidneys, which provides interaction with the aorta and inferior vena cava.

With pathological weakness of the fixing apparatus of one or both kidneys, omission occurs, which is called the wandering kidney, or nephroptosis.

Causes of pathology

The most common variant of nephroptosis is excessive mobility of the right side. This is due to the fact that the angle between the renal connecting plates on the right side is greater. Most often, the disease affects women.

The main reasons for the development of nephroptosis:

• untrained muscles of the abdominal wall;
• muscle relaxation during repeated pregnancies with subsequent childbirth;
• low weight or a decrease in body fat with rapid weight loss;
• weight lifting;
• intense bouts of coughing;
• long walk;
• sports exercises related to jumping;
• excessive tension during bowel movements;
• bruises and damage to the kidney area;
• pathological family inheritance.

Main symptoms

The complexity of diagnosing nephroptosis is associated with the absence of characteristic symptoms. The development, severity and variations of manifestations are purely individual. The most common signs:

1. Pain in the renal region: near the ilium and in one of the hypochondria (nephroptosis on both sides is rare). A characteristic feature of such pain is its reduction or complete disappearance in the supine position. With increased mobility on the right, pain affects the right side of the lower back, on the left, respectively, the left.
2. Renal manifestations: the occurrence of heaviness in the lower back on the affected side, the appearance of cystitis, urethritis, pyelonephritis, pain like renal colic, laboratory tests may detect protein in the urine.
3. Hemodynamic changes: sharp jumps in blood pressure, increased heartbeat, with laboratory diagnostics, the presence of hematuria is possible.
4. Neurological symptoms: neuralgia of the sciatic, femoral and other regional nerves, irritability, irascibility, hypochondria or hysteria.
5. Digestive disorders: loss or lack of appetite, feeling of heaviness in the abdomen, constipation, diarrhea.
6. General: fatigue, frequent dizziness, sleep disorders.

Stages of pathology

Manifestations of symptoms of nephroptosis depend on the stage of the disease. Wandering kidney has 3 stages of development:

1. The kidney is 1/3 out of the hypochondrium and is well palpated on inspiration, regardless of the constitution of the patient (normally, it is palpated only in very thin people). On exhalation, it returns to the hypochondrium.
2. The mobile kidney is well palpable in the standing position, as it completely leaves the hypochondrium. As a result of mobility around its leg, the renal vessels suffer, they twist, bend, stretch. In the prone position, she returns to her seat.
3. The kidney leaves the hypochondrium and shifts to the pelvic region. In this case, a kink of the ureter is possible, which leads to a gradual expansion of the renal-pelvic system, stagnation and the development of hypoxia.

All changes that occur with the renal vascular bed negatively affect the functioning of the organ. Such a pathological condition often leads to venous insufficiency and stagnation, the occurrence of urostasis, and the creation of favorable conditions for infection of the urinary system.

Diagnostic studies

The diagnosis for further treatment of nephroptosis is carried out as follows:

• Collection of anamnesis regarding the presence of previous injuries of the renal region, performance of work that provokes the development of nephroptosis, family heredity in kidney diseases.
• A detailed clarification of the symptoms that disturb the patient, the establishment of a connection between the development of signs of pathology and a sharp weight loss, the performance of physical activity, a change in body posture.
• Palpation of the kidney in the horizontal and vertical position of the patient, in which the organ is easily palpable.
• Conducting excretory urography, which determines the stage of the disease, the degree of displacement and the severity of dysfunction.
• Ultrasound examination allows you to study in detail the structure of the organ, the fixation apparatus and the exact location.
• Angiography and duplex examination help determine the presence of pathological changes in the renal artery.
• The functional state is assessed by isotope renography or nephroscintigraphy.

Treatment Methods

Treatment of nephroptosis is divided into etiological, palliative and symptomatic:

1. Etiological treatment is rarely performed, as it is a surgical operation in which the kidney is fixed by attaching a segment of lumbar muscle fibers to it. This method is called nephropexy. Currently, laparoscopy is used for its implementation.

1. Increased mobility of the kidney can be eliminated by palliative therapy, which is aimed at alleviating human suffering and creating comfortable living conditions for incurable pathology. In the case of the development of nephroptosis, such therapy is the selection and wearing of a bandage or corset that will securely fix the renal region.

1. Symptomatic treatment of the wandering kidney involves the elimination of individual pathological manifestations that have arisen:

• With the development of pain syndrome, antispasmodic and analgesic drugs are taken.
• In the case of neuralgia, anti-inflammatory drugs and multivitamins based on group B are prescribed.
• Infection of the urinary system is eliminated by the use of antimicrobial agents and so on.

Treatment of any signs is carried out only after the diagnosis and prescription of drugs by an experienced specialist.

In addition to drug treatments for nephroptosis, it is recommended to perform special exercises necessary to strengthen the muscles of the back and abdomen, conduct a course of therapeutic massage, resort and sanatorium activities, with low body weight, it is desirable to follow a diet that stimulates proper weight gain.

The main guarantee of a favorable outcome in any disease is the timely conduct of adequate treatment and further prevention of relapse. Advanced forms of pathologies, regardless of their origin and localization, are difficult to treat and, as a rule, leave multiple consequences. The wandering kidney is no exception.

Renal pathology, characterized by increased mobility of the kidney, is called nephroptosis. Nephroptosis is observed - the descent of the kidney from the physiologically correct place (lumbar region) to the lower abdomen, even the pelvis. Sometimes the situation improves, the floating kidney returns on its own, but most often it remains lowered at the site of displacement and it is difficult to raise it without surgery. What is a wandering kidney and why does such a disease occur?

General information

Two kidneys of a healthy person are in the renal bed, in a fixed position, and can vertically fall by 1-2 cm. This is the norm, the movement is associated with breathing. The left kidney is located lower, the right one is higher and touches the liver with its upper angle, so the omission of the right kidney is more common than the left one. On one side, an artery, a vein approaches it, on the other side, the ureter departs. The left and right organs hold the ligaments of the liver and spleen. The relaxation of the ligaments under the influence of various factors can lower one or two organs.

The displacement of the kidney leads to a violation of the direction of the vessels, flexion of the ureter. This creates favorable conditions for the development of the inflammatory process: deterioration of the blood supply to the tissue, urinary retention in the organ. A group of reactions of the body is directed to compensate for the impaired function at the expense of healthy systems, which means that the disease does not manifest itself for a long time. This aggravates the condition, since the consequences are much more dangerous than the disease, and can lead to pathological changes in the organ.

Types and stages of the disease

Nephroptosis of the kidneys is mobile (wandering) and fixed, moderate, one- or two-sided. With the omission of a kidney of a fixed type, there are three stages in the development of a pathological condition. The degree of prolapse of the organ affects the determination of the stage of nephroptosis. The classification is as follows:

• 1 stage. When inhaling, the kidney is clearly palpable below the anterior wall of the abdominal cavity. When exhaling, the organ goes under the ribs.
• 2 stage. The organ in the vertical position of the body completely falls from under the ribs, which is characteristic of a progressive disease. Having taken a horizontal position, the kidney is able to return to its normal position on its own or it can be painlessly set.
• Grade 3 nephroptosis is the most complex pathology. The organ completely comes out from under the ribs in any position of the body. There is a great danger of lowering the organ into the pelvic area.

With excess weight, it is impossible to feel the prolapse of the kidneys.

Depending on the degree of complexity, the following classification of species is distinguished:

1. Nephroptosis of the right kidney is the most common. In women, nephroptosis of the right kidney is more common than in men, since they have reduced elasticity of the muscle membrane.
2. Left-sided nephroptosis (less common than right-sided nephroptosis).
3. Bilateral nephroptosis is the rarest pathology in which both kidneys descend: both on the left and on the right. Most often, a hereditary predisposition leads to such a condition.

Causes of the disease

What are the reasons for the change in the functions of the body? Kidney prolapse occurs for a number of reasons, but the main ones are:

• sudden weight loss or excess body weight weaken the muscles and disrupt the fat layer;
• injured lumbar (bruise, muscle strain);
• heavy physical exertion, provoking stretching of the ligaments of internal organs;
• pregnancy;
• hereditary predisposition and intrauterine development (inverted).

risk zone

In some patients, doctors observe the rapid development of complications, while in others, moderate nephroptosis may remain at the initial stage for a long period of time. To answer the question of why this happens, doctors can only identify a risk group. Allocate a group of patients most susceptible to this disease. It is they who are rapidly developing internal mobility of organs. The first in the risk group are patients with curvature of the spine, athletes. A separate group includes those who are predisposed to severe stretching of the connective tissue and the elderly. Their connective tissue is less dense, which means that the risk of organ mobility is higher.

In children, kidney nephroptosis, as shown by a medical study, occurs in any age period. In most cases, the cause of the pathology is the pathological mobility of the kidney and the deformation of the skeleton. During the intensive growth of the child, the risk of developing the degree of pathology increases. Bilateral nephroptosis is extremely rare.

Symptoms

Most often, there are no symptoms of nephroptosis. If, with a lowered kidney (on both sides), there is no violation of urination and blood supply to the organ, the signs of the clinical picture will be blurred. Appearing pain in the lumbar region is often attributed to a violation of the articular cartilage of the spine, as they quickly disappear in the supine position. Often, nephroptosis on the right is mistaken for inflammation of appendicitis due to the similarity of symptoms. The severity of signs of pathology directly depends on the degree of its development and, in addition to pulling pain in one of the sides of the lower back, a person is able to feel:

• neurological disorders (migraine, dizziness);
• loss of appetite;
• nausea;
• high blood pressure (renal pressure is difficult to control, therefore dangerous);
• the protective functions of the body are lowered, inflammatory processes develop.

Methods for diagnosing a lowered kidney

When analyzing urine, especially in the early stages, it is possible not to reveal the presence of pathology, therefore, when the kidney is lowered, it is possible to determine the diagnosis if ultrasound or urography is done. That is why it is so important to immediately consult a doctor if you experience discomfort in the lumbar region. Recognition and confirmation of the degree of nephroptosis of both sides takes place in several stages:

• Examination of the patient, palpation on the left and right in a standing position, collecting information about the medical history, prescribing tests for further examination.
• ultrasound. The procedure is done vertically, which allows you to determine the condition of the arteries, ducts, show the pathology of the kidney and help answer the question of why the prolapse occurred. When conducting ultrasound in the supine position, the probability of detecting pathology is less.
• They do general blood and urine tests, which can determine the presence of an infection or inflammatory process in the body.
• A biochemical blood test is done with the assumption of the presence of renal complications, it is able to show the state of the work of the whole organism as a whole.
• The doctor receives the final confirmation during urography. Overview and excretory urography allows you to track the dynamics of the work and suggest the further development of the pathology.

The answer to the question of how to treat kidney prolapse is of interest to many. In modern medicine, nephroptosis therapy is carried out in many ways. Increased mobility of the kidney is treated with conservative and surgical methods, taking into account all contraindications. In the early stages, the treatment of nephroptosis is carried out by conservative methods. Raising a kidney at a later stage of development of the pathology, when the process is dangerous, is possible only in an operative way.

A wandering kidney is such a fairly common phenomenon, when the kidney, instead of being in its rightful place (in the lumbar region), suddenly begins to move down. Moreover, the movement can be not only in the abdomen, but also in the pelvis! This phenomenon is called nephroptosis. Of particular interest to physicians is the fact that after some time this body may return to its original place without any medical intervention, or may not return.

Most often, the wandering kidney is observed in the fair sex, rather than in men. It is quite simple to explain this - the female body is built in such a way that it implies a wide pelvis, the ligaments are more elastic.

It should be noted that the kidneys generally have a certain mobility (however, many organs differ in this). But at the same time they have a certain place in the human body. Few people know that when a person inhales, the kidney drops a couple of centimeters, if the breath is deep, then we can talk about 6 cm. There is also a certain reaction to the movement of the body and the movements performed. It is this oscillatory effect of physiological orientation that is the direct cause of the normal functioning of urination.

However, it happens that control over the organ is lost, the ligamentous apparatus is not able to hold the kidney in its place, as a result of which it is impossible to predict its movements. And her wandering around the body begins, it is chaotic, up and down, numerous turns can be made around the horizontal and vertical axes. It is noteworthy that after wandering like this for some time, the organ most often returns to where it should be, but then the wanderings begin again. The danger lies in the fact that if the kidney has moved somewhere and stays there for a long time, then the adhesive process may begin and the organ will remain there forever.

What are the symptoms

It is very interesting that this disease does not have any specific manifestations. After some time of its journey through the body, the wandering kidney can give itself out with certain sensations that are of an unpleasant nature. They are observed in the lumbar region, and in the vast majority of cases (75%), very unpleasant sensations are felt on the right side, rarely on both sides, and most rarely on the left. Painful sensations of a pulling nature are the most common symptoms, but sometimes the pain can be acute. It is noteworthy that at the very beginning of the disease there are no strong pain sensations, if it starts to hurt, it quickly passes and the person does not attach any importance to this. But after a while (this is both months and years), the pain becomes severe and sometimes unbearable.

At first, pain is felt after a certain physical work, after a person has lifted weights. Also, when the working day has come to an end, when a person is tired after work, or after a strong cough. If a person lies on his back or on the side in which it hurts, then the pain decreases.

With nephroptosis, the pain can be very strong, exhausting, and it is advisable to make a comparison with hepatic colic. They are often of a sudden nature, and they can be caused not only by strong physical stress, but also by a sharp change in body position from a horizontal to a vertical state. The duration of pain can be different (sometimes just a couple of minutes, sometimes 4-5 hours), it can become stronger, then weaker and stronger again. Pain can be given in the groin area, in the genitals. It often happens that vomiting can be the cause of an attack and a person is sick. A person turns pale sharply, cold sweat is released, and the temperature becomes high.

However, pain is not the only indicator. Often we can talk about the fact that a person suddenly experiences problems with appetite, in the lower abdomen there are unpleasant sensations, nausea. There are problems with the chair. In no case should you joke with such a disease, since after some time this can lead to serious problems in the nervous system. A person begins to get excited over trifles, neurasthenia may develop. Often patients with such a disease are not only hyperexcitable, they are irritable, suspicious, do not show confidence in doctors. They get tired quickly, they have trouble sleeping, they may have palpitations.

There are three stages of the disease:

Causes of nephroptosis

The causes of such a disease can be various factors. Most often, we are talking about factors that contribute to the fact that the ligamentous apparatus of the kidney undergoes changes. We can talk about a sharp weight loss about diseases of an infectious nature. Often, the disease can occur during pregnancy, when the tone of the abdominal muscles becomes lower. Various injuries in which overstretching is observed, ruptures of the ligamentous apparatus - all this also takes place. The reasons for all this can be a sharp lifting of excessive weights, falling from a great height and much more.

What are the possible complications

When the kidney moves down, the ureter begins to twist, making it difficult for a person to go to the toilet. When urinary retention occurs, stagnation occurs, urine becomes more and more, the outflow is poor, all this can end very badly before hydronephrotic transformation.

Pyolonephritis - that's what this disease leads to in a large number of cases, that is, we are talking about an inflammatory process. The disease can be acute, the pain syndrome is akin to hepatic colic, it is natural that emergency medical care is needed here.

The renal artery can be very stretched, it is not uncommon for its length to become 2 times larger, while its narrowing occurs. As a result of this, renal hypertension may develop, this is accompanied by blood pressure. It is dangerous that medical treatment here helps with difficulty. There is a lack of blood, oxygen and essential nutrients, resulting in hypertensive crises.

Diagnosis of the disease

The diagnosis can be made on the basis of the patient's complaints, it must be carefully examined by palpation (when the kidney is palpated). Instrumental and laboratory studies are used.

Urine taken for analysis often contains protein, leukocytes. X-ray and ultrasound are the most effective diagnostic methods for this disease. X-ray of the urinary system, urography, and the pictures must be made of both the lying patient and the standing one. Often there is a need to study all organs of the gastrointestinal tract.

Treatment

Treatment options may be different, you can use a conservative method, if it is inappropriate, then you should stop at the surgical one. If the disease could be identified at an early stage, when severe pain is not observed, then it is recommended to use conservative methods. Orthopedic treatment in this respect gives the most effective results. Every morning you need to do a specially designed bandage. That is, at the beginning of the day, without getting out of bed, the bandage is put on the stomach (the person must stand and take a deep breath), in the evening it is carefully removed. To date, there is a wide choice of different means, however, it should be borne in mind that each such device must be made individually for each patient.

There are contraindications for such treatment - the kidney is in a new place for a long time, it is already subject to fixation through the adhesive process. And in other cases, orthopedic treatment is acceptable.

In the first stages of the disease, treatment in a sanatorium helps in an excellent way, you need to massage the stomach, do therapeutic exercises (it strengthens the abdominal and back muscles), promotes normal pressure inside the abdominal cavity and helps limit the downward movement of the kidneys.

If we talk about drugs, then they cannot be used to install the kidney in place. But for the treatment of complications of such a disease, medications are excellent. Most often, effective drugs that have an anti-inflammatory effect are prescribed. It happens that the disease has developed due to the fact that a person was malnourished, as a result of which he lost weight, then intensive nutrition of the patient is indicated for normal weight gain.

A good effect is given by certain physical exercises that help strengthen the abdominal press.

However, it happens that all conservative treatment methods cannot give the desired effect. Then it is necessary to turn to surgical methods and only in this way can the kidney be fixed in its proper place. The kidney is fixed to the anatomical structures that are in close proximity, this is called nephropexy). Such an operation is carried out by a urologist, he returns the organ to its previous bed, after which it fixes it.

Laparoscopic method of fixation in modern medical practice is the most effective. In this operation, the abdominal cavity must be punctured, using special-purpose manipulators and a camera for tracking. If the operation is performed on time, then the result of treatment in most cases is positive. A person gets rid of arterial hypertension forever, problems with blood pressure no longer bother him.