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Hydronephrosis

Rohanjit S Sidhu, MD and Pang-Yen Fan, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Hydronephrosis refers to a structural finding—dilatation of the renal calyces and pelvis.

    • May occur with urinary tract infection (UTI), vesicoureteric reflux (VUR), high urine outpu...

DIAGNOSIS

Symptoms vary according to cause, chronicity, location, and degree of obstruction. 

HISTORY

  • Although often asymptomatic, hydronephrosis can be associated with pain ranging from vague, intermit...

TREATMENT

GENERAL MEASURES

  • Medical treatment: correction of fluid and electrolyte abnormalities, pain control, antibiotics as an adjunct to drainage if infection present

  • Relief of obstruction: prompt dr...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Serial monitoring of kidney function (electrolytes, BUN, and creatinine) and BP until renal function stabilizes. Frequency of monitoring depends on severity of re...

REFERENCES

1
Worster A, Preyra I, Weaver B, et al. The accuracy of noncontrast helical computed tomography versus intravenous pyelography in the diagnosis of suspected acute urolithiasis: a meta-analys...

ADDITIONAL READING

Shen P, Jiang M, Yang J, et al. Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis. J Urol.  2011;1...

CODES

ICD10

  • N13.30 Unspecified hydronephrosis

  • N13.39 Other hydronephrosis

  • Q62.0 Congenital hydronephrosis

  • N13.2 Hydronephrosis with renal and ureteral calculous obstruction

  • N13.1 Hydronephrosis w ureteral ...

CLINICAL PEARLS

  • US and noncontrast CT identify most causes of hydronephrosis.

  • Relief of obstruction, when present, is the primary treatment.

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