Is Severe Hydronephrosis Leading to Kidney Atrophy a Major Health Concern?

Q: Is Severe Hydronephrosis Leading to Kidney Atrophy a Major Health Concern?

Hello： <br>1. <br>According to the regulations on major illnesses from the Department of Health website (http：//www.nhi.gov.tw/webdata/AttachFiles/Attach_1059_1_W0940043268衛署941221公告重大傷病範圍表.doc)： <br> - Chronic renal failure (uremia) requiring regular dialysis treatment is clas

Is having a single kidney due to severe hydronephrosis resulting in kidney atrophy considered a major illness?

Dear Dr.
Pei,
I would like to ask you a few questions, and I appreciate you taking the time to respond amidst your busy schedule.

When my child was four to five months in utero, severe hydronephrosis was detected in the left kidney, which had enlarged to 4.5 cm.
Amniocentesis confirmed that the chromosomes were normal.
Now that my child is one year and four months old, everything seems to be fine, but I still have some concerns:
1.
During a recent ultrasound examination, it was confirmed that the left kidney has completely atrophied and is non-functional.
Would this be considered a significant health issue?
2.
My child's overall development appears to be normal.
Is there a need for any further kidney-related examinations?
3.
Will this condition have any impact on future military service?
4.
In daily life, should we only be cautious about dietary preferences (avoiding overly salty foods), refraining from indiscriminate use of traditional Chinese medicine, avoiding injury to the lower back, and ensuring adequate hydration? Based on your expertise, are there any other recommendations we should follow?
Thank you once again.

Danxin de muqin, 20~29 year old female. Ask Date: 2007/01/02

Dr. Pei Rensheng reply Pediatrics

Hello:
1.
According to the regulations on major illnesses from the Department of Health website (http://www.nhi.gov.tw/webdata/AttachFiles/Attach_1059_1_W0940043268衛署941221公告重大傷病範圍表.doc):
- Chronic renal failure (uremia) requiring regular dialysis treatment is classified as a major illness.

(a) Chronic renal failure
(b) Hypertensive nephropathy with renal failure
(c) Hypertensive heart and kidney disease with renal failure
Therefore, having one normal kidney does not classify as a major illness.
2.
The child's developmental milestones appear normal; however, it is still necessary to conduct kidney examinations every six months to a year, including ultrasound or blood tests to check BUN and creatinine levels.
3.
According to the military service physical examination guidelines (http://tnda.tncg.gov.tw/army/bodycheck/10.asp), a soldier with unilateral renal hydronephrosis and moderate to severe renal function impairment, while the contralateral kidney is normal, is classified as unfit for military service.
4.
In daily life, it is important to monitor dietary intake to avoid excessive seasoning, refrain from indiscriminate use of medications (both Western and traditional), avoid injury to the lower back, maintain adequate hydration (as fluid intake may need to be restricted in renal failure), and not hold urine.
Additionally, kidney examinations should be conducted every six months to a year, including ultrasound or blood tests to check BUN and creatinine levels.
Wishing you health and happiness!
Sincerely,
Pei Ren-Sheng

Reply Date: 2007/01/02

More Info

Severe hydronephrosis, particularly when it leads to kidney atrophy, is indeed a significant health concern. In your case, the left kidney's complete atrophy and loss of function following severe hydronephrosis can have implications for your child's overall health and future medical considerations.

1. Assessment of Kidney Atrophy: The fact that your child's left kidney has completely atrophied and is non-functional is a serious condition. This is classified as a significant health issue because the kidneys play a crucial role in filtering waste products from the blood, regulating blood pressure, and maintaining electrolyte balance. With one kidney non-functional, the remaining kidney must compensate for the loss. If the remaining kidney is healthy, it can often manage these functions adequately, but it is essential to monitor its health regularly.

2. Further Kidney Evaluations: Given that your child has a history of severe hydronephrosis and now has a non-functional kidney, it is advisable to continue regular follow-ups with a pediatric nephrologist. While your child appears to be developing normally, periodic assessments, including blood tests to monitor kidney function (like serum creatinine and electrolytes) and possibly imaging studies, can help ensure that the remaining kidney is functioning well.
3. Impact on Military Service: Regarding military service, the specific requirements can vary by country and military branch. Generally, having one non-functional kidney may not automatically disqualify someone from service, but it could depend on the overall health of the remaining kidney and any associated health issues. It would be best to consult with a military recruiter or medical officer for precise information.

4. Daily Life and Health Management: In terms of daily life, you are correct in emphasizing the importance of a balanced diet, avoiding excessive salt, and staying hydrated. These practices can help support kidney health. Additionally, avoiding unnecessary medications, especially those that could harm kidney function, is crucial. Regular check-ups with a healthcare provider are essential to monitor kidney health and manage any potential complications.

5. Additional Recommendations: Besides the points you've mentioned, consider the following:
- Education: Educate your child about the importance of kidney health and the need for regular check-ups.

- Physical Activity: Encourage regular physical activity, which is beneficial for overall health.

- Avoiding High-Risk Activities: Since your child has one functioning kidney, it may be wise to avoid contact sports or activities that could risk injury to the remaining kidney.

- Hydration: Ensure your child stays well-hydrated, as this can help the remaining kidney function optimally.

In conclusion, while your child’s development seems normal, the history of severe hydronephrosis and the current status of the left kidney warrant ongoing medical oversight. Regular follow-ups with a pediatric nephrologist will be key in managing your child's health and ensuring that any potential issues are addressed promptly. Thank you for your thoughtful questions, and I wish you and your child the best in health and well-being.

Similar Q&A

Understanding Kidney Hydronephrosis: Risks and Management Strategies

Hello Doctor: My father is in his fifties, and I would like to ask you about the potential harm that hydronephrosis could cause to his body, as well as how it should be managed.

Dr. Xie Yonghui reply Internal Medicine
According to your letter, I was unable to understand your father's condition, only that he has hydronephrosis. Hydronephrosis is generally caused by urinary tract obstruction. The most important step is to identify the underlying cause and pursue active treatment. I recommen...

Understanding Hydronephrosis: Causes and Management Strategies

Hello Doctor: I am currently 29 years old, 153 cm tall, and weigh 53 kg. Recently, I have been experiencing severe cramping pain in my lower abdomen, often to the point of breaking into a cold sweat, which led me to visit a gynecologist. The gynecologist found no issues and recom...

Dr. Du Shixi reply Urology
Hello: The information provided here is for reference only and cannot replace a physician's examination, testing, or diagnosis. 1) For right renal hydronephrosis, it is recommended to go to the hospital for further evaluation, as the urine shows no abnormalities. It is hig...

Understanding Hydronephrosis: Causes, Symptoms, and Complications

Dr. Hsu, what is hydronephrosis? What complications can it cause, and what are the underlying causes?

Dr. Xu Weikai reply Urology
Hello, A-Hong: General hydronephrosis refers to the accumulation of fluid in the kidneys. There are many causes, including ureteral stones, benign prostatic hyperplasia, tumors, infections, and kidney inflammation, among others. Treatment should be based on the underlying cause. ...

Preventing and Managing Kidney Atrophy: Essential Strategies for Health

If there is kidney atrophy, how can we prevent its progression and what are the treatment options? Thank you.

Dr. Hong Hongchang reply Internal Medicine
If kidney atrophy occurs, it indicates the onset of chronic nephritis or may lead to chronic kidney failure in the future. Dietary considerations should include a low-sodium diet and appropriate intake of protein and fluids. Additionally, unnecessary medications should be avoided...