Hydronephrosis in Infants: Causes, Risks, and Treatment Options

Pediatric hydronephrosis

Is hydronephrosis in infants very serious? My son has had mild hydronephrosis since the ultrasound examination during pregnancy.
He is now four months old, and during a recent check-up, the doctor mentioned that there is still hydronephrosis, with one kidney measuring 6 cm and the other 2 cm.
The doctor said to recheck in three months.
Is this concerning? Can medication or surgery resolve the issue? Will it affect his future development or growth? Additionally, what causes hydronephrosis? Is it related to the mother's diet during pregnancy, or is it hereditary? What is the general incidence rate in infants? Thank you.

Xiao Lin, 20~29 year old female. Ask Date: 2004/12/08

Dr. Tu Xiuhong reply Urology

Hello! The purpose of the follow-up regular assessments is to determine whether the hydronephrosis is continuing to worsen or showing improvement.
If it continues to worsen, it is essential to identify the cause, which is not necessarily genetic, as the incidence in infants is generally low.
Sincerely, Dr.
Tu Hsiu-Hong, Attending Physician, Department of Urology, Hsinchu Hospital, Ministry of Health and Welfare.

Reply Date: 2004/12/08

More Info

Hydronephrosis in infants is a condition characterized by the swelling of a kidney due to a build-up of urine. This occurs when there is an obstruction in the urinary tract, preventing urine from draining properly from the kidney to the bladder. Understanding the causes, risks, and treatment options for hydronephrosis is crucial for parents, especially when it is detected in newborns or infants.

Causes of Hydronephrosis
Hydronephrosis can be caused by several factors:
1. Congenital Abnormalities: Many cases of hydronephrosis in infants are due to congenital abnormalities, such as ureteropelvic junction obstruction (UPJ), where the connection between the kidney and the ureter is narrowed. This can lead to urine backing up into the kidney.

2. Urinary Tract Obstruction: Other obstructions can occur anywhere along the urinary tract, including the ureters, bladder, or urethra. Conditions such as posterior urethral valves (a blockage in the urethra) can also lead to hydronephrosis.

3. Reflux: Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and kidneys, potentially causing swelling.

4. Infections: Urinary tract infections can lead to inflammation and swelling, contributing to hydronephrosis.

5. Genetic Factors: Some cases may have a genetic component, where family history plays a role in the likelihood of developing hydronephrosis.

Risks and Implications
The severity of hydronephrosis can vary significantly. In your case, where one kidney shows 6 cm of swelling and the other 2 cm, it is essential to monitor the situation closely. While mild hydronephrosis may resolve on its own, significant swelling can lead to complications such as:
- Kidney Damage: Prolonged pressure from accumulated urine can damage kidney tissue, potentially leading to chronic kidney disease.

- Infection: The stagnant urine can become a breeding ground for bacteria, increasing the risk of urinary tract infections.

- Hypertension: In some cases, hydronephrosis can lead to high blood pressure due to kidney dysfunction.

Treatment Options
The treatment for hydronephrosis depends on the underlying cause and the severity of the condition:
1. Observation: In many cases, especially if the hydronephrosis is mild and there are no symptoms, doctors may recommend a watchful waiting approach. Regular follow-up ultrasounds can help monitor the condition.

2. Medications: If there is an infection or other complications, medications such as antibiotics may be prescribed.

3. Surgery: If the hydronephrosis is severe or does not improve, surgical intervention may be necessary. Procedures can include:
- Pyeloplasty: This surgery corrects a blockage at the ureteropelvic junction.

- Ureteral Stenting: A stent may be placed to help drain urine from the kidney.

- Vesicoureteral Reflux Repair: If reflux is the cause, surgical correction may be needed.

Impact on Development
As for the impact on your child's growth and development, mild hydronephrosis often does not affect overall health or development. However, significant hydronephrosis that leads to kidney damage can have long-term effects. Regular monitoring and timely intervention are crucial to prevent complications.

Dietary and Genetic Considerations
Regarding your question about maternal diet during pregnancy, while a healthy diet is essential for fetal development, hydronephrosis is typically not caused by maternal dietary choices. Genetic factors can play a role, but hydronephrosis is relatively common in infants, and many cases resolve without intervention.

Conclusion
In summary, while hydronephrosis can be a serious condition, many infants with mild cases do well with careful monitoring. It is essential to maintain regular follow-ups with your pediatrician or a pediatric nephrologist to ensure your child's health and development are on track. If you have concerns about your child's condition, do not hesitate to discuss them with your healthcare provider, who can provide personalized guidance and support.

Similar Q&A

Understanding Hydronephrosis in Infants: Risks and Treatment Options

My son is currently 8 months old and was diagnosed with hydronephrosis at birth. The doctor advised follow-up every six months. The results from last week's examination showed no changes, and the doctor suggested another follow-up in six months. Could you please explain what...

Dr. Pei Rensheng reply Pediatrics
Hello: 1. If the hydronephrosis is < 10 mm and there is no trend of enlargement, just perform ultrasound follow-up every six months. 2. If the hydronephrosis is between 10-15 mm, a voiding cystourethrogram (VCUG) or a functional renal imaging study (diuretic renography) shou...

Understanding Hydronephrosis in Infants: Risks and Surgical Options

Hello Doctor: My baby was born about 37 days ago and was hospitalized due to a fever. After examination, the doctor found a urinary tract infection that has affected the kidneys. The doctor mentioned that both kidneys are at grade 4 hydronephrosis and that surgery is necessary. I...

Dr. Pei Rensheng reply Pediatrics
Hello: For infants with urinary tract infections, general practitioners typically perform ultrasound examinations and arrange for a voiding cystourethrogram after treatment. The doctor mentioned that both kidneys are classified as grade 4 hydronephrosis, which likely refers to th...

Understanding Pediatric Hydronephrosis: Causes and Treatment Options

Good afternoon. My daughter was diagnosed with congenital hydronephrosis at the age of 11. Her left kidney had already become swollen due to fluid accumulation, causing severe pain that made her vomit. She required surgery, and the doctor said it would be a minor procedure to rem...

Dr. Zhong Ruixian reply Pediatrics
Dear Mother Tu, If renal hydronephrosis causes symptoms of a certain severity, it requires intervention. The treatment depends on the location and degree of obstruction: 1. If the child has congenital ureteral stenosis, a double-J ureteral stent can temporarily replace the uret...

Understanding Ureteral Stricture and Hydronephrosis in Infants

Hello, doctor! My sister's baby was born with unilateral hydronephrosis. Now that the baby is one month old, a check-up revealed ureteral stricture, and the affected kidney has become twice the size of a normal one. Can a one-month-old child undergo surgery? When is the most...

Dr. Pei Rensheng reply Pediatrics
Dear Ms. Wang, Hello, 1. According to http://www.healthcommunities.com/ureteropelvic-junction-obstruction/children/treatment-for-upj-obstruction.shtml 2. Treatment for Ureteropelvic Junction Obstruction: Newborns with UPJ obstruction and hydronephrosis are placed on antibioti...