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Nephroptosis is a pathological condition in accordance with which the kidney has increased mobility in relation to the norm. The female part of the population is more susceptible to nephroptosis.
In most cases, nephroptosis occurs on the right side. Nephroptosis can develop after dramatic weight loss, after pregnancy and childbirth.
The beginning of the development of nephroptosis is characterized by the presence of a pulling and aching pain in the patient, which disappears in the patient's lying position, but as the disease develops, the pain intensifies and is often not eliminated in a horizontal position.
Nephroptosis is associated with increased kidney mobility. If we talk about the norm, then the kidney is able to make vertical movements of one or two centimeters. The state of nephroptosis is associated with a situation where the kidney is able to move from the lumbar region to the pelvis or abdomen. Sometimes, after the displacement, the kidney returns to its proper place, sometimes this does not happen.
Dramatic weight loss is a factor in the development of nephroptosis. It really is. Nephroptosis can develop as a result of sudden weight loss, for example, due to an infectious disease. However, dramatic weight loss is not the only factor in the development of nephroptosis, which also include the following. Trauma in the abdomen and lumbar region can lead to damage to the ligaments, which ensure the localization of the kidney in a strictly established place by nature. As a result of trauma, a perirenal hematoma can occur. The latter is capable of "pushing" the kidney from its usual place - nephroptosis develops. Pregnancy and childbirth can lead to the development of nephroptosis. This situation is due to the fact that the abdominal wall is weakened during pregnancy.
Nephroptosis is dangerous. This is not entirely true. In fact, the possible consequences of nephroptosis are more dangerous. However, one should understand what nephroptosis can lead to. The fact is that arteries and nerves approach each kidney of the human body. The ureter leaves the kidney. All vessels of the kidney are wide and short, therefore, as a result of a change in the position of the kidney - its displacement - these vessels are narrowed and stretched. The processes of vasoconstriction and stretching of the vessels lead to a deterioration in the blood supply to the kidney tissue, and can also contribute to the bending of the ureter. The latter leads to urinary retention in the kidney, that is, the normal outflow of urine is disrupted, which often leads to inflammation of the renal tissue, that is, pyelonephritis.
The beginning of the development of nephroptosis is characterized by the presence of aching pain. Aching and pulling pains are localized in the lumbar region. They are associated with a constant displacement of the kidney: the onset of the disease is characterized by the movement of the kidney from its usual place by four to six centimeters down at the moment when the person is in an upright position. As soon as the patient is in a horizontal position, the kidney returns to its usual place.
It should be noted that a patient with nephroptosis at the initial stage of the disease is disturbed by pain (which is pulling and aching) only when he is in an upright position, that is, stands; when the patient lies down (and the kidney returns to the lumbar region), the pain disappears.
The development of nephroptosis is associated with an increasing displacement of the kidney. A displaced kidney can even be felt in the navel area if the patient has a thin physique. When a person is in a horizontal position, the kidney is not always able to return to the lumbar region. Perhaps its return with the help of the efforts of the patient (hand). Pain with the progression of nephroptosis increases (especially if a person gives the body physical activity. Pain can be localized throughout the abdomen, they disappear if the patient, being in a horizontal position, returns the kidney to the lumbar region.
With nephroptosis, the kidney can shift even into the small pelvis. If the disease reaches the displacement of the kidney into the small pelvis, then the patient no longer has the ability to return the kidney to the lumbar region. This stage of nephroptosis is characterized by an even greater increase in pain that the patient has constantly (of varying intensity) - the pain does not recede when the patient is lying down. The pain is given to the lower back and sharply intensifies with physical exertion, as a result of which blood may appear in the patient's urine. This stage of nephroptosis in most cases leads to the development of complications such as pyelonephritis, nephrogenic arterial hypertension, hydronephrosis.
Nephroptosis is an easily diagnosed disease. After examining the patient and familiarizing himself with his complaints, the specialist directs the patient to do urine and blood tests, as well as an ultrasound examination of the abdominal organs. Intravenous urography is often used. Based on the data from these studies, the doctor confirms the diagnosis of nephroptosis.
Nephroptosis is treated conservatively. Only in cases of early stages of nephroptosis, when this disease has not yet led to the development of complications. Conservative methods include the use of a special bandage, which is worn by the patient from morning to evening, the performance of a special set of physical exercises for the patient. The purpose of these exercises is to strengthen your abdominal muscles. If a factor in the development of nephroptosis is a sharp weight loss in the patient, then a sufficient amount of food is required. The latter is aimed at ensuring that the patient can achieve the same weight.
Nephroptosis is treated with surgery. This treatment is necessary in case of advanced stages of the disease. The kidney in these cases is localized in the small pelvis. She cannot return to the lumbar region on her own. In this case, the patient is shown an operation - nephropexy. The essence of nephropexy is as follows: the kidney returns to its usual place and becomes stronger there.
For the very operation of the patient with nephroptosis is prepared for about fourteen days. This training includes, in particular, a course of anti-inflammatory treatment. Its purpose is to prevent the possible risk of infection spreading during surgery.
Preoperative preparation also includes the following measures: a few days before the scheduled operation (usually two to three days), a patient with nephroptosis is taught to be in a horizontal position with the foot end of the bed raised by twenty centimeters - after all, it is in such a lying position with the raised the patient's feet will be in the first days after the operation.
The postoperative period in the case of nephropexy is associated with the requirement of adherence to bed rest for two weeks (the first few days in the position with the raised foot end of the bed). The duration of bed rest is associated with the need to secure the kidney in its bed.
Surgical treatment of this disease is also necessary if the following complications of nephroptosis develop. This is a disruption of the patient's vital activity due to intense constant pain, the development of a chronic form of pyelonephritis in the patient, the detection of blood in the urine, the presence of persistent arterial hypertension, and a sharp decrease in the functionality of the kidney, which has shifted downward.
Nephroptosis can be prevented. This primarily applies to women who have recently been pregnant. They really need to pay close attention to their health. Light exercise is recommended. Especially these exercises should be aimed at strengthening the abdominal muscles.
Affects everyone: if suddenly, after a sudden weight loss or an abdominal injury (it can be a blow), pulling pains appear in the lumbar spine in an upright position of the body, which have the ability to miraculously disappear in a horizontal position of the body, then their disappearance should not be regarded as a miracle. In this case, it is worth contacting a urologist in order to prevent the development of nephroptosis at an early stage. After all, we are responsible for our health.