A wandering kidney ( nephroptosis, sagging kidney ) refers to a lowering of the kidneys, which can impede the flow of urine and lead to painful symptoms.
What is a wandering kidney?
The clinical picture of the wandering kidney has existed since the 9th century. The term nephroptosis has been used since 1885, but was initially used for different clinical pictures. One speaks of nephroptosis when the kidney sinks by about five centimeters when the body is upright. For high blood pressure overview, please visit homethodology.com.
A wandering kidney usually occurs between the ages of 18 and 45, with women being affected more often than men. Normally, the kidneys sink or rise when inhaling and exhaling, although mobility varies from person to person. A total of three degrees of mobility can be distinguished:
- With deep inhalation, the lower pole of the kidney sinks, but otherwise it remains behind the costal arch.
- When inhaling, the kidney lowers so far that the hand can be placed between the costal arch and the upper pole of the kidney for palpation.
- The kidneys move so freely that they are completely in front of the costal arch even when coughing or when the upper body is upright. It only returns behind the costal arch when the position changes.
Causes
One reason for the mobility of the kidney is insufficient fixation by blood vessels or the fat capsule, which is often due to weakened connective tissue. Slim people who have lost a lot of weight are particularly affected. In most cases, nephroptosis occurs in the right kidney.
Symptoms, Ailments & Signs
With an upright body position, the diseased kidney moves downward and can descend into the pelvis. In many cases, there are no symptoms, but pain can also occur due to the pulling effect on the renal vascular pedicle that occurs when the kidney descends. The main symptom is very often a unilateral abdominal or flank pain that gets worse with movement.
If the patient lies down, the pain usually disappears. Other symptoms include decreased urine production, vomiting, nausea and rapid heartbeat. As a result, reduced blood flow to the kidneys can also occur. It is also problematic if the ureter, which creates the connection between the kidneys and the urinary bladder, bends.
Urinary retention then occurs and severe kidney damage can occur. The renal pelvis or the calyx system can expand significantly and kidney stones can occur. Another consequence is inflammation of the renal pelvis or urinary tract infections. There are basically three groups of nephroptosis:
- Wandering kidneys that do not cause any discomfort
- Migrating kidneys with unclear symptoms without functional or anatomical disorders
- Migrating kidneys with complaints that can be precisely localized and in which there are clear functional and anatomical changes. Here colicky pain often occurs and patients complain of back pain when bending over.
Diagnosis & course of disease
After a medical history, the patient is first physically examined. A wandering kidney can be detected primarily by means of a special X-ray contrast agent examination or with the help of an ultrasound. In addition, other diseases such as bile duct and gastrointestinal diseases that cause similar symptoms or changes in the spine must be ruled out.
In women, a gynecological examination should also be performed. An isotope nephogram can provide information about whether there are obstructions to the flow. If the kidney sinks by two vertebral body heights and congestion can be detected, nephroptosis is assumed. The doctor can also detect a change in the position of the kidney on the X-rays.
As part of an isotope clearance, which is carried out lying down or sitting down, the renal blood flow or a possible obstruction of the urine flow can be examined. If hypertension is present, angiography can also be helpful.
When should you go to the doctor?
In the case of a wandering kidney, treatment by a doctor is usually always necessary. The person concerned should contact a doctor as soon as the first symptoms and symptoms appear, so that there are no further complications or a further deterioration of the symptoms. Early detection and treatment of the wandering kidney has a very positive effect on the further course. If left untreated, this disease can, in the worst case, lead to the death of the affected person. A doctor should be contacted if the patient suffers from severe pain in the kidneys or flanks.
As a rule, there is also severe nausea and vomiting, with most patients also suffering from a significantly increased heart rate. The symptoms do not go away on their own. It is not uncommon for urination to be associated with severe pain, which can also indicate a wandering kidney. If you have these symptoms, you should first contact a general practitioner or an internist. In emergencies or if the pain is very severe, an ambulance can be called directly or a hospital can be visited. In most cases, a wandering kidney can be treated well if it is detected early.
Treatment & Therapy
If there are no or only minor symptoms, a wandering kidney does not need to be treated. Medication is given for mild pain. As part of conservative therapy, the abdominal muscles are also strengthened. Another treatment option is to wear a corset.
If the symptoms cannot be improved by conservative therapy, surgery can be performed. This is indicated above all when the patients suffer from severe symptoms or urinary flow disorders. In this case, the kidney is fixed during an operation. The operation is performed under general anesthesia, with the surgeon first making an incision in the skin on the flank. The movable kidney is then attached to the lower edge of the ribs or to the back muscles with sutures. For a better grip, the doctor also makes indentations on the kidney capsule.
A drainage tube is then inserted to collect fluid from the wound. This hose is removed again after a few days. Normally, the operation can prevent the kidney from further sinking and the symptoms disappear. However, it cannot be ruled out that the mobility will continue or occur again.
Physical rest for six to twelve weeks is required after the operation. During this time, the patient should not lift anything heavy or cough as little as possible to prevent tearing of the sutures.
Prevention
To prevent nephroptosis, good posture should be maintained and standing in one place for long periods should be avoided. Training the abdominal muscles is also beneficial. Significant weight loss can also contribute to the development of a wandering kidney.
Aftercare
Wandering kidney is a common nephrological disease that is scientifically called nephroptosis. It is a lowering of the kidneys, which in most cases occurs due to reduced muscle tone or drastic weight loss. The kidney experiences a change in position when the body moves and sinks down due to gravity.
For this reason, nephroptosis is also referred to as “wandering kidney” or “sinking kidney”. The kidneys are connected by ends of vessels at the aorta and vena cava and by a layer of fat. A hereditary weakness of the connective tissue that indicates nephoptosis. A wandering kidney can also occur in people who are particularly light.
If the wandering kidney does not cause any symptoms, treatment is not necessary. However, due to the lowering of the kidneys, back and flank pain and recurring colic can occur, which are alleviated in a lying position. In addition, the ureter can kink and cause urinary retention or bloody urine.
This in turn is a common cause of kidney pelvic inflammation. Compression of the renal vessels and the resulting lack of blood flow can also lead to pain. Another secondary disease can be arterial hypertension due to vascular damage. Surgical fixation (nephropexy) of the kidney is unavoidable in severe symptoms.
You can do that yourself
In the case of nephroptosis, also known as wandering kidney disease, there are a few simple rules to alleviate the symptoms in everyday life. This is recommended for mild pain that is treated more conservatively and for which no medical therapy is necessary. Then the patient himself has the chance to improve his symptoms.
However, if the pain is severe, medical treatment or surgery is essential. Exercise often makes the pain worse. Standing for too long should also be avoided. Simply lying down can counteract this. Alternatively, medication for minor pain can be taken. Prophylactic training of the abdominal muscles strengthens the position of the kidneys and can thus contribute to an improvement. Since an insufficient layer of fat, in addition to a lack of muscles, also promotes sinking, the surrounding tissue can be stabilized with controlled weight gain.
Another option is to wear a corset in everyday life. This corrects posture when standing and sitting and reduces movement of the kidney. If, despite these measures, the pain worsens, we urgently recommend that you visit your doctor again.
