The accumulation of water, as the name suggests, is the obstruction of urine from the pelvis discharge process. After accumulation, the pyelone pressure increases and the pyelone’s renal expansion has led to a series of pathological processes such as renal atrophy and renal dysfunction.
Cumulative renal water can cause kidney cortex atrophy, and then affect renal function
Kidney accumulated water is often because some parts of the urinary system have obstruction, such as stenosis, stones, tumors and other factors
Then we briefly understand that the function of human urinary system is a whole.Under normal circumstances, it is in a low pressure state. The urine can be unidirectional from the kidney through the ureter to the bladder, and then the composite mechanism and other composite mechanisms such as urination reflection (plus a certain abdominal pressure) in the bladder can be eliminated by the urethra.That also means that obstructions caused by any part of the urinary system (external compression, inner blockage, tube wall disease, etc.) may cause renal water and even cause renal loss.
The human urinary system mainly includes kidney, ureter, bladder, and urethral composition. The formation of urine and excluding the in vitro by the above organs, maintaining the stable environment of the body
Therefore, we must pay attention to when we usually discover the accumulation of kidney water.Today, I will take everyone to understand the disease of kidney water.
1. What situation can cause kidney water?
As mentioned earlier, any cause of the obstruction of the urinary system may cause kidney water;
The common causes have the following situations:
1) Urinary tract stones: kidney, ureter, bladder, urethral stones, especially kidney stones and ureteral stones are the most common;
2) Urinary system tumors: kidney, renal pelvis, ureter, bladder, prostate, urethra, penile tumor may cause renal water;
3) Infection: Especially repeated urinary tract infections (renal pelvis, ureteral inflammation), urinary tuberculosis, some acute prostatitis;
4) Prostate hyperplasia, this is the common cause of some elderly men with bilateral renal water water
5) The specialty renal water caused by congenital factors: the most common is the narrowing of the pyelone’s ureter connection, and it is also found in congenital giant ureter, abnormal blood vessel compression, or posterior ureter, ureteral opening cyst and other diseases such as cavity venous.
6) Application of organ lesions around the surrounding organs: colorectal cancer, uterus, ovarian or cervical cancer, post -fibrosis of peritoneal, causing ureteral pressure, causing kidney water
7) Pregnancy: Nursery women during pregnancy are more common during pregnancy, mainly due to increasing uterine compression. Generally, it can be relieved after childbirth;
8) After the surgery of the urinary system: in vitro vibration ripples, ureteral stenosis caused by ureteral endoscopy operation, etc.
2. What is the discomfort of the human body?
Because of the different parts of urinary tract obstruction, the degree of obstruction, and duration of the obstruction, the clinical symptoms of kidney water water are not the same: in general, there is no symptom at the beginning of the accumulation of the kidney.After developing to a certain degree, symptoms such as backache, back pain, fever, hematuria.
Different causes lead to different symptoms of renal water: kidney accumulation caused by urinary system tumors, often combined with symptoms such as painless nourishing and hematuria; kidney accumulation caused by urinary stones often has backache and back pain, accompanied by disgusting, accompanied by nausea, Vomiting, even less urine, no urination, etc.; while lower urinary tract obstruction (prostate hyperplasia, narrow urethra, bladder export obstruction, etc.), kidney water accumulation will be combined with frequent urination, urgency, pain, dysuria, and even urine urine潴The performance.
If we usually find the waist and abdomen blocks, back pain, hematuria, difficulty in urination, or less urine, urine without urine, we must go to the hospital in time to clear the reason.
3. How to check the accumulated kidney water?
The most common situation we usually see in the outpatient clinic is because of health checkup or other departments discovered at the Blind Blind of the abdomen. 1) The abdomen B ultrasound is the first choice method for us to screen kidney water.Patients with pregnant women, fetuses, and even renal failure can also be checked.
Kidney B ultrasound can clearly show the accumulation of kidney water, clear whether there is stones, understand the structure of the pyelone, kidney cups, etc., simple, convenient, and non -invasive
2) CT/CTU: It can help diagnose stones, urinary tumors, understand the simplicity of renal water and kidney atrophy. Patients with normal renal function and further diagnosis are recommended. It is a recommended non -invasive examination.
CT can clearly understand the situation of the kidney, ureteral and surrounding tissue organs
3) Radioxin Nephrology (GFR): Understand the degree of damage to kidney and clear renal function
4) Tingoscope or ureteroscopy can be used for some patients with urinary tract obstruction, especially patients with stones, tumors, ureteral stenosis and other patients. They can clearly diagnose the same treatment at the same time.
5) Laboratory examination: It is mainly used to monitor renal changes, such as serum creatinine, creatinine clearance, etc.;
In addition, there are some examination methods, such as 6) Varicic urinary tract angiography: use cautiously for patients with decreased renal function, especially renal failure; this examination can understand the kidney size, morphology, obstruction severity, and obstruction side renal function; 7)Rebelling urinary tract angiography: If the urinary tract obstruction and the renal function is not good, in order to solve the area and lesions of the obstruction, you can be retrograde.However, the examination needs to be intubated by cystoscopy or ureter mirror to increase the patient’s pain and the risk of retrograde infection. It is generally not adopted now.8) Shunxing’s pyeline urinary circuit: You need to pierce the renal puncture fistula, which can display the expansion of the pelvis, kidney condition, and ureteral obstruction site and condition.
4. How to distinguish the weight of kidney water?
Usually we often see the B -ultrasound report that mild kidney accumulation, moderate kidney accumulation, or severe kidney accumulation water. So how can we judge the severity of the accumulated water?
The kidney B-ultrasound shows that the pyelone is separated by <10mm is normal. Some people may have a pelvic separation of about 10-20mm under urination. You can check the B-ultrasound when not urinating;10mm or the expansion of kidney cups is called kidney accumulation.
⑴ Mild renal accumulation: The kidney shape of the kidney is large and there are no obvious abnormal abnormal kidney substance and echo normal kidney set system to be separated by 20-30mm; ⑵ moderate kidney accumulation: mild renal volume, full shape, kidney essence mild changesThe display of thin and renal columns is not clear, the renal pelvis has expanded, and the pyelone gathering system is separated by 30-40mm; 3) severe renal accumulation: increased kidney volume, morphological disorders, significant renal essences or unable to display, and even the entire kidney kidneyThe zone is a liquid dark area.
5. Do you need to treat kidney accumulated water?
Is it necessary to treat kidney accumulated water, which is indeed related to the degree of water accumulation, but it is necessary to comprehensively judge the cause of the accumulation of kidney water, the degree of kidney water, and the part of the obstruction.It also needs to be determined in conjunction with the general situation of the patient.
In principle, if the renal function does not affect, try to remove the cause; if the renal function has an impact, then find a way to relieve obstruction first, alleviate the accumulation of kidney water at the same time;, Cause less urine, urine -free, etc., you need to drain the water for water (through ureteral stent tube, dilateral diuretic fistula diversion, etc.) to save renal function, and then find a way to remove the cause.For some accumulated water caused by acute obstruction, such as urinary system stones, acute urinary retention, etc., or the acute aggravation of chronic renal water accumulation, you need to solve the obstruction first, and then choose subsequent treatment.
In addition, if there is a mild kidney water, there is no symptoms. It is recommended to regularly review the follow -up observation, including the re -examination of the kidney B -ultrasound and kidney function, which may not necessarily need to be treated.
6. What are the treatment methods of kidney accumulated water?
The treatment of accumulated renal water is mainly to alleviate the accumulation of kidney water, protect renal function, and treat the cause of the cause. Therefore, the key to the treatment of renal water is to clarify the cause of the cause, the degree of water accumulation, location, and renal function.
Relieve renal water, protect renal function, and renal water caused by urinary tract obstruction: 1) ureteral stent reinstallation; 2) Diopytic kidney puncture fistula drainage; 3) ureteral skin stoma;Kidney water caused by obstruction: 1) Leave the urethra; 2) bladder puncture fistula, etc.
Treatment of the cause: 1) Treatment of urinary stones: in vitro vibration ripples or urinary tubes laser gravel, plywood with skin renal mirror, etc.; 2) urinary system tumorTumor, cervical cancer and other treatment to relieve compression of ureteral symptoms; 3) urinary tuberculosis: anti -tuberculosis treatment; 4) ureteral stenosis: ureteral expansion, molding, etc.
For the non -functional kidney (lost kidney) caused by severe renal hydronephrosis, it may cause renal hypertension, secondary renal pyelone nephritis to form pus, etc., and can consider non -functional renal resection.
