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Hydronephrosis describes hydrostatic dilation of the renal pelvis and calyces as a result of obstruction to urine flow downstream. Alternatively, hydroureter describes the dilation of the ureter, and hydronephroureter describes the dilation of the entire upper urinary tract (both the renal pelvicalyceal system and the ureter).
It is the most common cause of hydronephrosis detected in utero and is the most common anomaly detected on prenatal ultrasounds. [1] [2] It occurs in approximately 1 in every 1500 live births, is most commonly seen in males, involves the left ureter twice as often as the right ureter. [1] [2] UPJ obstruction is transient in most cases. [2]
It is the most common cause of bladder outlet obstruction in male newborns. The disorder varies in degree, with mild cases presenting late due to milder symptoms. More severe cases can have renal and respiratory failure from lung underdevelopment as result of low amniotic fluid volumes, requiring intensive care and close monitoring. [2]
The size of the renal pelvis plays a major role in the grading of hydronephrosis. Normally, the anteroposterior diameter of the renal pelvis is less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [2] In adults, 13% of the normal population have a transverse pelvic diameter of over 10 mm. [3]
Hydronephrosis is seen as an anechoic fluid-filled interconnected space with enhancement within the renal sinus, and normally, the dilated pelvis can be differentiated from the dilated calyces. [1] Figure 13. Hydronephrosis due to ureteropelvic junction obstruction in a pediatric patient. [1] Several conditions can result in urinary obstruction.
The fishhook ureter sign, also known as the "hockey stick" or "J-shaped" ureter sign, is a radiologic sign that has been used to describe the presence of a retrocaval ureter, which is an anatomical anomaly where the ureter abnormally runs posterior to the IVC.
The lungs contribute to acid-base homeostasis by regulating carbon dioxide (CO 2) concentration. The kidneys have two very important roles in maintaining the acid-base balance: to reabsorb and regenerate bicarbonate from urine, and to excrete hydrogen ions and fixed acids (anions of acids) into urine.
Shortness of breath due to extra fluid on the lungs (may also be caused by anemia) Polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause: Pain in the back or side; Healthy kidneys produce the hormone erythropoietin that stimulates the bone marrow to make oxygen-carrying red blood ...