How to check hydronephrosis better

In clinical practice, hydronephrosis often has no obvious symptoms. Therefore, if you want to make a clear diagnosis, you must pay attention to the reason for treatment and understand whether there are symptoms of low back pain, hematuria, or hypertension, as well as fever caused by secondary infection.

1. Low back pain is persistent dull pain or discomfort.

2. The lumps in the waist and abdomen initially start below the rib margin and gradually extend to the lateral abdomen and waist. Large ones may cross the midline and become cystic lumps with smooth surfaces, regular edges, a sense of fluctuation, and no obvious tenderness.

3. Hematuria is usually microscopic hematuria. Hematuria worsens after concurrent infection, stones or trauma.

4. Oliguria or anuria If water accumulates in both kidneys, but only one kidney, or only one functional kidney, and the patient's renal function is severely impaired, oliguria or anuria will occur.

5. Alternating oliguria and polyuria is seen in some patients with primary hydronephrosis. The lump may suddenly shrink and the pain may be relieved after urinating a large amount of urine. When the urine volume decreases, the lump will rapidly increase and the pain will worsen.

6. Hypertension: About 1/3 of patients with severe hydronephrosis have hypertension, which is mildly or moderately elevated. This may be due to renal parenchymal ischemia caused by compression of the interlobular arteries by the dilated renal pelvis and calyces.

7. Spontaneous renal rupture may cause renal pelvic rupture due to secondary infection without trauma, resulting in perinephric hematoma and urine extravasation. It manifests as sudden pain in the waist and abdomen, with widespread and obvious tenderness and muscle tension.

8. The body temperature rises when fever is followed by secondary infection.

9. Digestive tract symptoms may include abdominal pain, bloating, nausea, and vomiting. The above symptoms will worsen after drinking large amounts of water.

10. Bilateral obstruction leads to chronic renal failure and uremia.