Hydronephrosis in Infants: Causes, Effects, and Care Tips

Q: Hydronephrosis in Infants: Causes, Effects, and Care Tips

Hello concerned mother： Hydronephrosis refers to the dilation of the renal pelvis, which is the part of the kidney where urine is collected before it flows into the ureters and bladder. <br>When there is a narrowing or complete obstruction in this pathway within the kidney, urine

Pediatric hydronephrosis

Hello Dr.
Zhang,
My daughter is now 11 months old.
In April, I noticed that she didn't urinate much throughout the day (she also had a poor appetite and didn't drink much milk).
The next day, I took her to the hospital for a renal ultrasound, and the doctor informed me that she has mild hydronephrosis in her left kidney, which is still within an acceptable range, and we should recheck in six months.
Today, I took her for a follow-up, and the hydronephrosis in her left kidney is still present.
We will continue to monitor her every six months and see if there is any improvement by the time she is three years old, at which point we will decide on treatment options.
What is hydronephrosis? What causes it? How will hydronephrosis affect my daughter between the ages of one and three? If there are potential effects, how can I minimize them during this period? Will it impact her future life? What should I be aware of? If there is no improvement by the age of three, what treatment options are available that would be best for her?
Thank you for your response!
A concerned mother, 94.10.07

min, 30~39 year old female. Ask Date: 2005/10/07

Dr. Zhang Peixin reply Pediatrics

Hello concerned mother: Hydronephrosis refers to the dilation of the renal pelvis, which is the part of the kidney where urine is collected before it flows into the ureters and bladder.
When there is a narrowing or complete obstruction in this pathway within the kidney, urine accumulates and causes the renal pelvis to enlarge, similar to how a river creates a small pond when blocked by a large rock.
The most common site of narrowing occurs at the junction of the renal pelvis and the ureter.
If the narrowing is mild or partial, the overall pathway remains open, resulting in only mild hydronephrosis, which typically does not change significantly and does not impact kidney function or health.
The only consideration is that urine may accumulate in the renal pelvis for a period before being expelled, slightly increasing the risk of urinary tract infections.
However, if the narrowing is severe or there is a complete obstruction, hydronephrosis may present shortly after birth (within days to weeks), and it will appear increasingly severe on renal ultrasound.
In such cases, close monitoring and further nuclear medicine evaluation and surgical consultation are necessary.
Mild hydronephrosis alone does not affect a child's growth or health and usually does not require advanced nuclear medicine studies.
It is important to monitor for any unexplained fever lasting several days, in which case a hospital visit for urine testing and bacterial culture is advised to rule out urinary tract infection.
Additionally, renal ultrasounds should be followed up approximately every six months to a year, as mild hydronephrosis often resolves naturally as the child grows.
Sincerely, Dr.
Pei-Hsin Chang, Pediatrics.

Reply Date: 2005/10/07

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 that prevents urine from draining properly from the kidney to the bladder. In your daughter's case, the diagnosis of mild hydronephrosis in her left kidney suggests that while there is some swelling, it is currently within an acceptable range.

Causes of Hydronephrosis
Hydronephrosis can be caused by several factors, including:
1. Congenital Abnormalities: Some infants are born with structural abnormalities in their urinary tract that can lead to obstruction.

2. Urinary Tract Infections (UTIs): Infections can cause swelling and inflammation, leading to temporary hydronephrosis.

3. Vesicoureteral Reflux (VUR): This condition occurs when urine flows backward from the bladder into the kidneys, which can cause swelling.

4. Obstruction: This can occur due to stones, tumors, or scarring in the urinary tract.

Effects on Infants
The impact of hydronephrosis on your daughter will depend on the severity and underlying cause. Mild hydronephrosis may not cause any significant problems, especially if it is monitored regularly. However, if the condition worsens or is associated with other complications, it could potentially lead to:
- Kidney Damage: Prolonged pressure from the swelling can damage kidney tissue.

- Infection: Stagnant urine can increase the risk of urinary tract infections.

- Impaired Kidney Function: In severe cases, hydronephrosis can affect the kidney's ability to function properly.

Monitoring and Care Tips
Since your daughter is being monitored every six months, this is a good approach to ensure that any changes in her condition are detected early. Here are some care tips to help manage her condition:
1. Hydration: Ensure your daughter stays well-hydrated. Adequate fluid intake can help dilute urine and may reduce the risk of infection.

2. Watch for Symptoms: Be vigilant for signs of urinary tract infections, such as fever, irritability, or changes in urination patterns. If you notice any of these symptoms, consult your pediatrician promptly.

3. Regular Check-Ups: Continue with the scheduled ultrasounds and follow your doctor’s recommendations for monitoring her condition.

4. Diet: A balanced diet can support overall health. If your daughter has any dietary restrictions or needs, discuss them with her pediatrician.

Future Considerations
If your daughter's hydronephrosis does not improve by the age of three, further evaluation may be necessary. Treatment options could include:
- Surgical Intervention: If there is a significant obstruction, surgery may be required to correct the issue.

- Medication: In some cases, medications may be prescribed to manage symptoms or prevent infections.

Conclusion
While it is understandable to be concerned about your daughter's condition, many infants with mild hydronephrosis lead normal, healthy lives, especially with proper monitoring and care. It is essential to maintain open communication with your healthcare provider, who can provide guidance tailored to your daughter's specific situation. Regular follow-ups and being attentive to her health will help ensure that any potential issues are addressed promptly.

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