Kidney is an organ that has mobility. Normally, it can shift, but not more than a few centimeters. The omission of the kidney is scientifically called nephroptosis. Pathology is characterized by an abnormal displacement of the organ during any movement of a person by two or more vertebrae down. Omission of the right kidney is more common than the left. There is also nephroptosis of the entire paired organ at the same time, but this phenomenon is extremely rare. In the article we will talk about kidney prolapse, symptoms and consequences, causes and methods of treating pathology.
A bit of anatomy
The fixing device is designed to keep the kidney in its normal position. It includes the following structures:
- Vessels. They play an insignificant role in fixing the organ, because they can lengthen with nephroptosis.
- Fat capsule. It is a perirenal adipose tissue that performs a fixing, protective function.
- Fascial apparatus. The fascia is located outward from the fatty capsule, consists of the posterior and anterior layers. They grow together at the upper pole andform a suspension ligament, which passes into the connective sheath covering the diaphragm. The fascial apparatus plays an insignificant role in fixing the kidney.
- Abdominal ligaments. These are the folds of the peritoneum that cover the organ in front. The splenic-renal and pancreatic-renal ligaments fix the left kidney, the duodenal-renal and hepato-renal ligaments are designed to prevent prolapse of the right kidney. You will feel the symptoms of nephroptosis if the abdominal ligaments begin to stretch.
- Renal bed. Formed by the diaphragm, fascia, muscles of the abdominal wall.
Causes of nephroptosis
The amplitude of movement of the kidney is normally two to five centimeters (often 3.5 centimeters). But there are certain pathological factors that weaken the fixing apparatus, as a result of which the mobility of the organ increases, and the kidney prolapses.
In youth, nephroptosis can be caused by a sharp weight loss caused by malnutrition. Incorrectly selected physical activity and excessive sports, leading to sharp drops in intra-abdominal pressure, can also become provoking factors. Infectious diseases that occur chronically and are accompanied by weight loss can lead to depletion of the fat capsule that protects the organ from movement.
The omission of the kidney can also be associated with improper organization of labor, characterized by a long-term presence of a person in conditions of vibration. In addition, nephroptosis often develops as a result of injuries, especially afterfalls from a height, in which the integrity of the ligaments and fascia is broken. In this case, the fixation of the kidney becomes untenable. Perirenal hematomas resulting from trauma to the lumbar region or abdomen can also displace the organ.
Nephroptosis and pregnancy
Women who have already given birth may be more likely to develop kidney prolapse than women who have not given birth. This is due to a sharp decrease in intra-abdominal pressure after pregnancy due to weakening of the abdominal muscles. As a result, the fixing apparatus is also weakened, and this is already a factor predisposing to nephroptosis. The risk of pathology directly depends on the size of the abdomen during pregnancy, the degree of stretching of the anterior wall of the peritoneum, the number of births.
Prolapsed kidney: symptoms
Patients often do not notice any signs of pathology, and it is usually detected by chance during the examination. Indeed, the clinical manifestations of nephroptosis in the event of its occurrence without a violation of hemo- and urodynamics are extremely scarce. The severity of symptoms mainly depends on the degree of prolapse. Based on the clinical manifestations and characteristics of the pathology, there are three stages of nephroptosis.
First stage
One third of the kidney becomes available for palpation. Its lower edge is palpable at the height of inhalation, and on exhalation it goes into the hypochondrium. This stage proceeds without a pronounced clinical picture. If the organ descends seven centimeters or more, dull pains may occur, radiatingto the lumbar region. Their occurrence is associated with stretching of the fascial capsule.
Also, a person may experience pain during physical exertion, but at rest or when taking a horizontal position, when the organ takes its place in the renal bed, it usually disappears. When left kidney prolapse develops, symptoms may also include heaviness in the left hypochondrium.
Second stage
Almost the entire organ comes out from under the costal arch. The kidney in the vertical position of the body becomes two-thirds accessible for palpation, but still, when taking a horizontal position, it returns to the renal bed. As the degree of displacement increases, so does the symptomatology. The pain becomes more intense, reminiscent of renal colic. Unpleasant sensations occur with a sharp change in body position, and during physical exertion. In addition, there are changes in the urine: the level of erythrocytes and protein increases, which indicates stagnation of blood in the kidney due to impaired venous outflow.
Third stage
The entire organ comes out from under the costal arch, lowering occurs down to the small pelvis. The pain becomes constant and often also extends to the groin. Nausea and vomiting may occur. At this time, complications are already developing, including hydronephrosis of the kidney, pyelonephritis, arterial hypertension. Due to such complications, as well as due to a long interruption of the blood supply during urination, fornical bleeding can occur. There is a risk of the patient developing psycho-emotional disorders: neurasthenia, insomnia, depression, dizziness attacks, overexcitability, fatigue, loss of appetite.
Diagnosis of nephroptosis
In the early stages, as already mentioned, kidney prolapse is often detected by chance, although the patient may go to the doctor with complaints of recurrent back pain. The main diagnostic method is urography (X-ray examination with contrast). It is carried out in horizontal and vertical positions. In this way, the degree of nephroptosis can be reliably determined. At a later stage of the pathology, when erythrocytes are already present in the urine, veno- and arteriography (renal vessel studies) are the most informative diagnostic method. They are carried out in a vertical position. This method makes it possible to determine with accuracy how much blood circulation is disturbed in the vessels of the organ.
Prolapsed kidney: treatment
Nephroptosis can be treated conservatively and promptly. When choosing the first option, it will not be possible to eliminate the pathology, but unpleasant consequences can be prevented. The patient should use a bandage when lowering the kidneys, perform special exercises, eat hard (but at the same time correctly) eat.
The operation is prescribed only in the case when there are sharp pains and complications that prevent a person from moving and deprive him of his ability to work, such as vasorenal hypertension, hydronephrotic transformation, pyelonephritis, fornic bleeding,progressive pyelectasis.
Conservative Therapy
The first thing the doctor prescribes is to wear a bandage when the kidneys are lowered. If you start using it at an early stage of nephroptosis, you can protect yourself from the progression of the pathology and the development of complications. Only in a horizontal position while exhaling should you put on a bandage, do this after waking up, even before getting out of bed.
It is also necessary to perform special exercises when lowering the kidney in order to strengthen the muscles of the anterior wall of the peritoneum. The most effective is the exercise "swallow". Lie on your stomach on a hard surface and very slowly lift your legs brought together, arms and head outstretched to the sides. Fix this position and hold it for a while, and then slowly return to the starting position. Take some rest and repeat the exercise. You need to do at least fifteen to twenty repetitions, then lie on your stomach for a couple of minutes without moving, then turn on your back and rest for at least half an hour. At first, you will feel pain in the kidney area, but it will decrease with each time. But remember: the exercises that you are going to perform when lowering the kidney must be coordinated with the doctor.
Traditional medicine
As you already understood, neither with the help of drugs nor with the help of exercises will it be possible to eliminate the prolapse of the kidney. Treatment with folk remedies will also not return the organ to its place, but it can prevent and eliminate numerous complications.
- When nephroptosis shoulduse an infusion of knotweed. Take it three times a day, one hundred grams, half an hour before meals.
- Worth a try is this method: sprinkle a handful of flaxseed with water and sprinkle with half a teaspoon of powdered sugar, then fry it all a little in an ungreased frying pan. Chew the seeds like regular seeds whenever you feel like it. It is also very useful to take sunflower and pumpkin seeds, any nuts.
- Pour two tablespoons of broom kochia (herb) into a thermos, pour one and a half cups of boiling water and leave overnight. The next morning, strain the resulting infusion and drink fifty milligrams between meals.
- Use scissors to finely chop one kilogram of oat straw and pour twenty liters of water. Boil for an hour on low heat, then cover and leave for another two hours. Use the resulting warm decoction in the mornings and evenings for sitz baths (every other day). Baths should be taken after the main water procedures are carried out. The infusion is allowed to be used several times.
- Take echinacea tincture, eleutherococcus extract, multivitamins to boost immunity.
Surgical treatment
As a result of the operation, the kidney is fixed, that is, its pathological mobility is eliminated. As already mentioned, nephroptosis is not always an indication for surgical intervention, but only in the presence of serious complications. Before the operation, as a rule, for three days the patient is recommended to sleep on a bed with a slightly raised foot end. It helps to bring backbody to its normal position and facilitates the process.
During surgery, the kidney is fixed against the muscles of the abdominal wall. There are several methods, the choice of a specific method is carried out on the basis of the clinical picture. After the operation, the patient should also lie on the bed, which has a raised foot end. This is necessary for a faster and more successful recovery. This regimen should be followed for several days, after which the beds are given a normal position, and the patient is allowed to get up and walk.
Anti-inflammatory therapy is carried out for another two weeks after surgery. At this time, the patient should avoid sudden or prolonged straining during defecation. If necessary, microenemas or mild laxatives can be used. It should be noted that in almost all patients the operation is successful.
Consequences of nephroptosis
Kidney prolapse is a pathology that needs mandatory treatment. Otherwise, the likelihood of developing unwanted complications is extremely high. Nephroptosis provokes a violation of the urinary outflow, which, in turn, leads to an increase in pressure inside the kidney. Even at a time when the pathology still does not manifest itself in any way, complications may already arise in the renal parenchyma.
When the normal outflow of urine from the kidney is disturbed, a dangerous disease develops - pyelonephritis. It can disrupt a person's usual life, and sometimes the symptoms are so painful that emergency medical attention is required.help.
Prolapsed kidney can cause hypertension, which increases the risk of stroke. Among other things, nephroptosis often leads to the formation of kidney stones. Pathology is dangerous for women in case of pregnancy: due to the prolapse of the organ, spontaneous miscarriage can occur.
