Hydronephrosis is distension and dilation of the renal pelvis and calyces caused by obstruction of free flow of urine from the kidney, leading to progressive atrophy of the kidney.

Hydronephrosis may be unilateral involving just one kidney or bilateral involving both.

A complication of hydronephrosis is decreased kidney function.

The increased pressure of extra fluid within the kidney decreases the blood filtration rate and may cause structural damage to kidney cells.

This decrease in function is reversible if the underlying condition is corrected but if the hydronephrosis lasts many weeks, the damage may be permanent.

Causes:

There are numerous causes of hydronephrosis that are categorized based on whether the cause is intrinsic (located within the urinary collecting system) or extrinsic (outside of the collecting system).

Examples of Intrinsic Causes of Hydronephrosis

Ureter

•Kidney stone: causes obstruction of the ureter as it moves from the kidney into the bladder via ureter so, urine will back up and cause the kidney to swell.
•Stricture or scarring

Bladder

•Bladder stones
•Cystocele
•Bladder neck contracture

Urethra

•The inability to empty the bladder for any reason may cause bilateral hydronephrosis.
• Urethral stricture

Examples of Extrinsic Causes of Hydronephrosis

Ureter

•Tumors or cancers that compress the ureter and prevent urine flow
•Retroperitoneal fibrosis
•Cancer of cervix
•Cancer of prostate
•Pregnancy
•Uterine prolapse
•Scarring due to radiation therapy

Symptoms:

Acute hydronephrosis:

1.Back pain radiating to groin
2.Nausea
3.Vomiting
4.Blood in the urine

Chronic hydronephrosis:

1.Weakness
2.Malaise
3.Nausea
4.Vomiting
5.Electrolyte abnormalities
6.Muscle spasms

Diagnosis:

Taking the history of signs and symptoms.

Reviewing the patient’s past medical history and family history and Physical examination

Laboratory Tests

The following laboratory tests may be useful:

1.Urinalysis to look for infection or abnormal cells.
2.Complete blood count(CBC) may reveal.
3.Electrlyte analysis may be helpful in chronic hydronephrosis since the kidneys are responsible for maintaining and balancing their concentrations in the blood stream.
4.BUN(blood urea nitrogen), Creatinine and glomerular filteration rate(GFR) are blood tests that help to assess the kidney function.

Imaging Studies

1.CT scan of the abdomen can be performed to evaluate the kidney anatomy and make the diagnosis of hydronephrosis
2.Ultrasound is another imaging study that can be done to look for hydronephrosis.
3.Intravenous pyelography (IVP)
4.KUB X-rays (an X-ray that shows the kidney, ureter, and bladder)

Treatment:

The treatment for hydronephrosis is to restart the free flow of urine from the kidney and decrease the swelling and pressure that builds up and decreases kidney function.

The initial care for the patient is to minimize pain and preventing urinary tract infections.

Otherwise surgical intervention may be required.

Shock wave lithotripsy (SWL or extracorporeal shock wave lithotripsy)

Bladder catheterization

Stent placement

Complications :

kidney infections (pyelonephrosis),
sepsis
complete kidney function loss
death

Prevention:

Since hydronephrosis is a situation that occurs because of an underlying cause, prevention depends upon avoiding the underlying cause.

For example, individuals with kidney stones that cause ureteral obstruction and hydronephrosis can be avoided by decreasing the chance of stone recurrence by keeping well hydrated.

Homoeopathic Treatment:

1.Berberis vulgaris:

a.cutting pain or a burning feeling that extends to the urethra
b.The passage may also burn at times when no attempt at urination is being made.
c.After emptying the bladder, the person feels as if some urine still remains inside.
d.Urging and discomfort are often worse from walking.
e.indicated mainly in left-sided renal stones.

2.Sarsaparilla:

a.Frequent urging is felt, with burning pain at the end of urination.
b.Urine passes when the person is standing up, but only dribbling occurs while sitting.
c.Flakes or sediment are sometimes seen in the urine.
d.excruciating pains from right kidney downwards.

3.Lycopodium:

a.This remedy may be helpful if a person has to urinate frequently during the night and passes large amounts of urine.
b.the person may feel a painful urge, but has to strain to make the urine flow.
c.Pain may be felt in the back before the urine passes

Some people have their own remedies to reduce back pain. Not all of these remedies include medication and most can be attempted without experiencing any side effects. These remedies will not work for everyone because each injury can be a result of multiple different things. This article will give a brief description of five of the most common remedies. These remedies include breathing techniques, white willow bark, music therapy, capsaicin cream, and acupuncture.

Breathing techniques have been used for many years to cure back pain. Almost every breathing specialist will have a different method, but they all concentrate on one thing. All breathing techniques are focused around knowing how to properly breathe with your stomach. When breathing in your belly should be pushed put, however many people’s belly comes in as they inhale. By not breathing correctly you can be putting stress on multiple parts of your back. Most people do not think about breathing and do not know that by breathing properly you can reduce your pain.

The willow bark remedy is not so common. Using willow bark to cure pain dates clear back to Ancient Egyptian times. Willow bark contains a pain reliever called salicin. Upon entering the body salicin is converted to salicylic acid. Salicylic acid is known to relieve pain and inflammation. This method does however have some side effects. Salicylic acid can cause stomach ulcers, so therefore willow bark should be used in moderation.

Music therapy is common, however many people do not believe it works. Some people find music therapy a silly remedy of curing back pain but the truth is that is has been tested and proven to work. People that have tried music therapy normally like it. All music therapy sessions may be different but most commonly people relax while listening to southing music three to four times a day. This method of deep relaxation will calm the nerves and muscles thus reducing pain.

Capsaicin cream has also been around for many years. It has the same active ingredient as a chili pepper. When eating a chili pepper a hot tingling sensations over comes the mouth. The same concept is used in capsaicin cream. Capsaicin cream can be purchased at any drugstore and is sold over the counter. Capsaicin cream has the same effect on the body as a prescribed pain killer, however it does not work as quickly nor does it have the same side effects. Capsaicin cream is applied to the skin at the area where pain is experienced three to four times a day. Most people who have used capsaicin cream have found the end result to be successful.

The last remedy is acupuncture. Acupuncture is a traditional technique used by the Chinese. It is offered by a variety of physicians, but can sometimes be expensive. Acupuncture is performed by placing needles into the top layers of skin. There are many different theories about how acupuncture works. Most people think that when the needles are placed the brain is sent a signal that calms the nervous system. This may be true, but all that is known for sure is that acupuncture has a high success rate.

Although vitamin C (ascorbic acid) is the most popular vitamin supplement in the United States, in many respects it is the most controversial. Over the years many respected scientists have shared polarized views on the importance of vitamin C supplementation to human health. While researchers and experts may argue just how much vitamin C we need to consume, one thing about vitamin C is not controversial its essential role in human nutrition.
Food Sources

While most people think of citrus fruits as the best source of vitamin C, vegetables also contain high levels, especially broccoli, peppers, potatoes, and brussels sprouts. Exposure to air destroys Vitamin C, so it is important to eat fresh foods as quickly as possible. Although a salad from a salad bar is a healthier lunch choice than a hamburger, the vitamin C content of the fruits and vegetables from a salad bar is only a fraction of what it would be in a fresh salad. For example, freshly sliced cucumbers, if left standing, lose 41 percent and 49 percent of their vitamin C content within the first 3 hours. A sliced cantaloupe left uncovered in the refrigerator loses 35 percent of its vitamin C content in less than 24 hours.

Deficiency Signs and Symptoms

While most other animals can manufacture their own vitamin C, the human body does not have this luxury. Throughout history humans have suffered from the vitamin C-deficiency disease known as scurvy. The classic symptoms of scurvy are bleeding gums, poor wound healing, and extensive bruising. In addition to these symptoms, susceptibility to infection, hysteria, and depression are also hallmark features.

Scurvy affected many people in ancient Egypt, Greece, and Rome. Scurvy undoubtedly molded world history because rations supplied during military campaigns and long ocean voyages seldom contained adequate amounts of vitamin C.

During some parts of history, scurvy hit a population just like the plague. Between 1556 and 1857, for example, 114 epidemics of scurvy were reported during the winter months, when fresh fruits and vegetables are not available. Even more severe was the devastating scurvy associated with long sea voyages.

Some explorers, like Jacques Cartier in 1856, learned that eating certain foods helped cure scurvy. Cartier’s crew ate spruce tree needles; other crews ate oranges, lemons, limes, and berries. In 1742, British physician James Lind wrote the first real scientific discussion about the possibility that scurvy was a dietary deficiency. In his classic experiment, Lind demonstrated that patients given lemon juice recovered from scurvy. Although some explorers adopted Lind’s finding by rationing citrus fruits on long voyages Captain James Cook’s crew avoided scurvy altogether in his three long voyages between 1768 and 1779 the British Navy did not adopt the use of lime juice rations for its crews until 1804, some 62 years after Lind’s discovery. Today’s mainstream medical community appears to have adopted the same timeline for integrating scientific information about the importance of nutrition.

Vitamin C was identified as the “antiscorbutic principle” and was first isolated by Albert Sent-Gyorgyi in 1928. Nearly 70 years later, researchers are still discovering health-promoting benefits for ascorbic acid. Although scurvy is now rare in our society, subclinical or marginal vitamin C deficiency is common, especially in the elderly. The following table illustrates the percentages of population groups with unequivocally low vitamin C levels as determined by measuring the vitamin C content of the buffy coat layer of blood. The buffy coat consists of all the cellular components of blood, but primarily white blood cells.