Hydronephrosis is a condition where one or both kidneys become stretched and swollen as a result of a build-up of urine inside the kidney(s).
It can affect people of any age and is sometimes spotted in unborn babies during routine pregnancy ultrasound scans (this is known as antenatal hydronephrosis).
Hydronephrosis doesn't generally cause any long-term problems if it's diagnosed and treated promptly. Babies with the condition may not require any treatment at all.
However, the condition can increase your chances of getting urinary tract infections (UTIs). In severe cases that are left untreated, the kidney(s) may become scarred, which could lead to loss of kidney function (kidney failure).
Hydronephrosis in babies
Hydronephrosis is increasingly being found in unborn babies during routine ultrasound scans. This is known as antenatal hydronephrosis. It's estimated to occur in at least 1 in every 100 pregnancies.
As a parent, it can be worrying to learn your baby has a problem with their kidneys. However, most cases of hydronephrosis in babies aren't serious and shouldn't affect the outcome of your pregnancy.
About four out of every five cases will resolve on their own before or within a few months of birth and will cause no long-term problems for you or your baby. The remaining cases may require treatment with antibiotics to prevent kidney infections, and in some cases surgery may be needed.
Signs and symptoms
Hydronephrosis doesn't always cause symptoms. If it does, these may develop quickly over a few hours or gradually over weeks or months.
Symptoms can include:
- pain in your back or side – this may be sudden and severe, or may be a dull ache that comes and goes over time; it may get worse after you've drunk a lot
- symptoms of a UTI, such as a high temperature (fever) of 38C (100.4F) or above, chills and feeling or being sick
- blood in your urine
- urinating less often than you used to or with a weak stream
- in severe cases, noticeably swollen kidneys
You should see your GP if you develop severe or persistent pain in your back or side, have symptoms of a UTI, or notice a change in how often you urinate. They may refer you for an ultrasound scan to assess your kidneys.
Hydronephrosis in babies doesn't usually cause symptoms, but you should seek medical advice as soon as possible if your child develops signs of a possible UTI, such as a high fever without any other obvious cause.
Causes of hydronephrosis
Hydronephrosis diagnosed in pregnancy is usually mild. It is thought to be caused by an increase in the amount of urine your baby produces in the later stages of pregnancy.
In more severe cases, it may be caused by a blockage in the flow of urine from the kidney(s) to the bladder, backflow of urine from the bladder to the kidney(s), or a blockage in the flow of urine out of the bladder.
In adults, hydronephrosis is commonly caused by:
- kidney stones
- an enlarged prostate gland in men
- narrowing of the ureters (the tubes that carry urine from the kidneys to the bladder) because of injury, infection or surgery
- some types of cancer, including kidney cancer, bladder cancer, prostate cancer or ovarian cancer
If you have hydronephrosis, your treatment will depend on what's causing the condition and how severe it is. Pregnant women and babies with the condition may not require any treatment.
In adults, the first stage of treatment is often to drain the urine out of your kidneys by inserting a tube called a catheter into your bladder or kidney(s). This will help relieve the pressure on your kidneys.
Once the pressure has been relieved, the cause of the build-up of urine may need to be treated. The treatments used will depend on why the condition developed. For example:
- kidney stones may be removed during an operation or broken up using sound waves
- an enlarged prostate can be treated with medication or surgery to remove some of the prostate
- blockages in the ureters can be treated using surgery to insert a small tube called a stent
- cancer may be treated using a combination of chemotherapy, radiotherapy or surgery to remove the cancerous tissue