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<li id="toc-Grading" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Grading"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Grading</span> </div> </a> <ul id="toc-Grading-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Hydronephrosis</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 36 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-36" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">36 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D9%88%D9%87_%D8%A7%D9%84%D9%83%D9%84%D9%8A%D8%A9" title="موه الكلية – Arabic" lang="ar" hreflang="ar" data-title="موه الكلية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A5%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7%D0%B0" title="Хидронефроза – Bulgarian" lang="bg" hreflang="bg" data-title="Хидронефроза" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%98%E0%BD%81%E0%BD%A3%E0%BC%8B%E0%BD%98%E0%BC%8B%E0%BD%86%E0%BD%B4%E0%BC%8B%E0%BD%96%E0%BD%A6%E0%BD%82%E0%BD%A6%E0%BC%8B" title="མཁལ་མ་ཆུ་བསགས་ – Tibetan" lang="bo" hreflang="bo" data-title="མཁལ་མ་ཆུ་བསགས་" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target"><span>བོད་ཡིག</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hidronefrosi" title="Hidronefrosi – Catalan" lang="ca" hreflang="ca" data-title="Hidronefrosi" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Hydronephrose" title="Hydronephrose – German" lang="de" hreflang="de" data-title="Hydronephrose" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%80%DE%A6%DE%87%DE%A8%DE%91%DE%B0%DE%83%DE%AF%DE%82%DE%AC%DE%8A%DE%B0%DE%83%DE%AF%DE%90%DE%A8%DE%90%DE%B0" title="ހައިޑްރޯނެފްރޯސިސް – Divehi" lang="dv" hreflang="dv" data-title="ހައިޑްރޯނެފްރޯސިސް" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/H%C3%BCdronefroos" title="Hüdronefroos – Estonian" lang="et" hreflang="et" data-title="Hüdronefroos" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Hidronefrosis" title="Hidronefrosis – Spanish" lang="es" hreflang="es" data-title="Hidronefrosis" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%87%DB%8C%D8%AF%D8%B1%D9%88%D9%86%D9%81%D8%B1%D9%88%D8%B2" title="هیدرونفروز – Persian" lang="fa" hreflang="fa" data-title="هیدرونفروز" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Hydron%C3%A9phrose" title="Hydronéphrose – French" lang="fr" hreflang="fr" data-title="Hydronéphrose" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%88%98%EC%8B%A0%EC%A6%9D" title="수신증 – Korean" lang="ko" hreflang="ko" data-title="수신증" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Hydronephrosis" title="Hydronephrosis – Hausa" lang="ha" hreflang="ha" data-title="Hydronephrosis" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B5%D6%80%D5%AB%D5%AF%D5%A1%D5%B4%D5%AB_%D5%BB%D6%80%D5%A1%D5%AF%D5%A1%D5%AC%D5%B8%D6%82%D5%B4" title="Երիկամի ջրակալում – Armenian" lang="hy" hreflang="hy" data-title="Երիկամի ջրակալում" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Hidronefrosis" title="Hidronefrosis – Indonesian" lang="id" hreflang="id" data-title="Hidronefrosis" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Idronefrosi" title="Idronefrosi – Italian" lang="it" hreflang="it" data-title="Idronefrosi" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%9E%D7%99%D7%99%D7%9E%D7%AA_%D7%91%D7%9B%D7%9C%D7%99%D7%94_(%D7%94%D7%99%D7%93%D7%A8%D7%95%D7%A0%D7%A4%D7%A8%D7%95%D7%96%D7%99%D7%A1)" title="מיימת בכליה (הידרונפרוזיס) – Hebrew" lang="he" hreflang="he" data-title="מיימת בכליה (הידרונפרוזיס)" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%93%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7" title="Гидронефроз – Kazakh" lang="kk" hreflang="kk" data-title="Гидронефроз" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%93%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7" title="Гидронефроз – Kyrgyz" lang="ky" hreflang="ky" data-title="Гидронефроз" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Waterzaknier" title="Waterzaknier – Dutch" lang="nl" hreflang="nl" data-title="Waterzaknier" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E6%B0%B4%E8%85%8E%E7%97%87" title="水腎症 – Japanese" lang="ja" hreflang="ja" data-title="水腎症" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B9%E0%AC%BE%E0%AC%87%E0%AC%A1%E0%AD%8D%E0%AC%B0%E0%AD%8B%E0%AC%A8%E0%AD%87%E0%AC%AB%E0%AD%8D%E0%AC%B0%E0%AD%8B%E0%AC%B8%E0%AC%BF%E0%AC%B8%E0%AD%8D" title="ହାଇଡ୍ରୋନେଫ୍ରୋସିସ୍ – Odia" lang="or" hreflang="or" data-title="ହାଇଡ୍ରୋନେଫ୍ରୋସିସ୍" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Gidronefroz" title="Gidronefroz – Uzbek" lang="uz" hreflang="uz" data-title="Gidronefroz" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Wodonercze" title="Wodonercze – Polish" lang="pl" hreflang="pl" data-title="Wodonercze" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Hidronefrose" title="Hidronefrose – Portuguese" lang="pt" hreflang="pt" data-title="Hidronefrose" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Hidronefroz%C4%83" title="Hidronefroză – Romanian" lang="ro" hreflang="ro" data-title="Hidronefroză" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%93%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7" title="Гидронефроз – Russian" lang="ru" hreflang="ru" data-title="Гидронефроз" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Hydronefr%C3%B3za" title="Hydronefróza – Slovak" lang="sk" hreflang="sk" data-title="Hydronefróza" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A5%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7%D0%B0" title="Хидронефроза – Serbian" lang="sr" hreflang="sr" data-title="Хидронефроза" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Hidronefroza" title="Hidronefroza – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Hidronefroza" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Hydronefroosi" title="Hydronefroosi – Finnish" lang="fi" hreflang="fi" data-title="Hydronefroosi" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Hydronefros" title="Hydronefros – Swedish" lang="sv" hreflang="sv" data-title="Hydronefros" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%93%D0%B8%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7" title="Гидронефроз – Tatar" lang="tt" hreflang="tt" data-title="Гидронефроз" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A0%E0%B8%B2%E0%B8%A7%E0%B8%B0%E0%B9%84%E0%B8%95%E0%B9%80%E0%B8%AA%E0%B8%B7%E0%B9%88%E0%B8%AD%E0%B8%A1%E0%B8%A1%E0%B8%B5%E0%B8%99%E0%B9%89%E0%B8%B3%E0%B8%84%E0%B8%B1%E0%B9%88%E0%B8%87" title="ภาวะไตเสื่อมมีน้ำคั่ง – Thai" lang="th" hreflang="th" data-title="ภาวะไตเสื่อมมีน้ำคั่ง" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Hidronefroz" title="Hidronefroz – Turkish" lang="tr" hreflang="tr" data-title="Hidronefroz" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%93%D1%96%D0%B4%D1%80%D0%BE%D0%BD%D0%B5%D1%84%D1%80%D0%BE%D0%B7" title="Гідронефроз – Ukrainian" lang="uk" hreflang="uk" data-title="Гідронефроз" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%85%8E%E7%A9%8D%E6%B0%B4" title="腎積水 – Chinese" lang="zh" hreflang="zh" data-title="腎積水" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q730877#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Hydronephrosis" title="View the content page [c]" accesskey="c"><span>Article</span></a></li><li id="ca-talk" class="vector-tab-noicon mw-list-item"><a href="/wiki/Talk:Hydronephrosis" rel="discussion" title="Discuss improvements to the content page [t]" accesskey="t"><span>Talk</span></a></li> </ul> </div> </div> <div id="vector-variants-dropdown" class="vector-dropdown emptyPortlet" > <input 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dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Dilation of the renal pelvis due to obstruction of urine flow</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Hydronephrosis</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Hydro.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/28/Hydro.jpg/220px-Hydro.jpg" decoding="async" width="220" height="180" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/28/Hydro.jpg/330px-Hydro.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/2/28/Hydro.jpg 2x" data-file-width="438" data-file-height="359" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Renal_ultrasonography" title="Renal ultrasonography">Renal ultrasonography</a> of hydronephrosis caused by a left ureteral stone</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Urology" title="Urology">Urology</a>, <a href="/wiki/Nephrology" title="Nephrology">nephrology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q730877?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table> <p><b>Hydronephrosis</b> describes hydrostatic dilation of the <a href="/wiki/Renal_pelvis" title="Renal pelvis">renal pelvis</a> and <a href="/wiki/Renal_calyx" title="Renal calyx">calyces</a> as a result of obstruction to <a href="/wiki/Urine" title="Urine">urine</a> flow downstream. Alternatively, <b>hydroureter</b> describes the dilation of the <a href="/wiki/Ureter" title="Ureter">ureter</a>, and <b>hydronephroureter</b> describes the dilation of the entire <a href="/wiki/Upper_urinary_tract" class="mw-redirect" title="Upper urinary tract">upper urinary tract</a> (both the renal pelvicalyceal system and the ureter). </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The signs and symptoms of hydronephrosis depend upon whether the obstruction is <a href="/wiki/Acute_(medicine)" title="Acute (medicine)">acute</a> or <a href="/wiki/Chronic_(medicine)" class="mw-redirect" title="Chronic (medicine)">chronic</a>, partial or complete, unilateral or bilateral. Hydronephrosis that occurs acutely with sudden onset (as caused by a <a href="/wiki/Kidney_stone" class="mw-redirect" title="Kidney stone">kidney stone</a>) can cause intense pain in the flank area (between the hips and ribs) known as a <a href="/wiki/Renal_colic" title="Renal colic">renal colic</a>. Historically, this type of pain has been described as "Dietl's crisis".<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Conversely, hydronephrosis that develops gradually over time will generally cause either a dull discomfort or no pain. Nausea and vomiting may also occur. An obstruction that occurs at the urethra or bladder outlet can cause pain and pressure resulting from distension of the bladder. Blocking the flow of urine will commonly be prone to <a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">urinary tract infections</a> which can lead to further development of stones, fever, and <a href="/wiki/Hematuria" title="Hematuria">blood</a> or <a href="/wiki/Pyuria" title="Pyuria">pus in the urine</a>. If complete obstruction occurs, a <a href="/wiki/Kidney_failure" title="Kidney failure">postrenal kidney failure</a> (obstructive nephropathy) may follow.<sup id="cite_ref-merck_2-0" class="reference"><a href="#cite_note-merck-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Blood tests may show impaired kidney function (elevated <a href="/wiki/Urea" title="Urea">urea</a> or <a href="/wiki/Creatinine" title="Creatinine">creatinine</a>) or electrolyte imbalances such as <a href="/wiki/Hyponatremia" title="Hyponatremia">hyponatremia</a> or <a href="/wiki/Hyperchloremic_acidosis" title="Hyperchloremic acidosis">hyperchloremic metabolic acidosis</a>. <a href="/wiki/Urinalysis" title="Urinalysis">Urinalysis</a> may indicate an elevated <a href="/wiki/PH" title="PH">pH</a> due to the secondary destruction of <a href="/wiki/Nephron" title="Nephron">nephrons</a> within the affected kidney, which impairs acid excretion. Physical examination in a thin patient may detect a palpable abdominal or flank mass caused by the enlarged kidney.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=2" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hydronephrosis is the result of any of several abnormal pathophysiological occurrences. Structural abnormalities of the junctions between the <a href="/wiki/Kidney" title="Kidney">kidney</a>, <a href="/wiki/Ureter" title="Ureter">ureter</a> and <a href="/wiki/Bladder" title="Bladder">bladder</a> that lead to hydronephrosis can occur during fetal development. Some of these congenital defects have been identified as inherited conditions, however, the benefits of linking <a href="/wiki/Genetic_testing" title="Genetic testing">genetic testing</a> to early diagnosis have not been determined.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Other structural abnormalities could be caused by injury, surgery, or radiation therapy.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p><p>The most common causes of hydronephrosis in children are anatomical abnormalities. These include <a href="/wiki/Vesicoureteral_reflux" title="Vesicoureteral reflux">vesicoureteral reflux</a>, <a href="/wiki/Urethral_stricture" title="Urethral stricture">urethral stricture</a>, and <a href="/wiki/Stenosis" title="Stenosis">stenosis</a>. The most common cause of hydronephrosis in young adults is <a href="/wiki/Kidney_stone" class="mw-redirect" title="Kidney stone">kidney stones</a>. In older adults, the most common cause of hydronephrosis is <a href="/wiki/Benign_prostate_hyperplasia" class="mw-redirect" title="Benign prostate hyperplasia">benign prostate hyperplasia</a> (BPH), or <a href="/wiki/Pelvic_cavity" title="Pelvic cavity">intrapelvic</a> <a href="/wiki/Neoplasm" title="Neoplasm">neoplasms</a> such as <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a>.<sup id="cite_ref-:0_4-0" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Compression of one or both ureters can also be caused by other developmental defects not completely occurring during the fetal stage such as an abnormally placed vein, artery, or tumor. Bilateral compression of the ureters can occur during <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> due to enlargement of the <a href="/wiki/Uterus" title="Uterus">uterus</a>. Changes in hormone levels during this time may also affect the muscle contractions of the bladder, further complicating this condition.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p><p>Sources of obstruction that can arise from other various causes include kidney stones, <a href="/wiki/Thrombus" title="Thrombus">blood clots</a> or <a href="/wiki/Retroperitoneal_fibrosis" title="Retroperitoneal fibrosis">retroperitoneal fibrosis</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A 2019 review found three cases of hydronephrosis with <a href="/wiki/Renal_colic" title="Renal colic">renal colic</a> were caused by malpositioned <a href="/wiki/Menstrual_cup" title="Menstrual cup">menstrual cups</a> pressing on a ureter. When the cups were removed, the symptoms disappeared.<sup id="cite_ref-Lancet_review_6-0" class="reference"><a href="#cite_note-Lancet_review-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>The obstruction may be either partial or complete, and can occur anywhere from the <a href="/wiki/Urethral_meatus" class="mw-redirect" title="Urethral meatus">urethral meatus</a> to the <a href="/wiki/Renal_calyces" class="mw-redirect" title="Renal calyces">renal calyces</a>. Hydronephrosis can also result from the retrograde flow of urine from the bladder back into the kidneys (<a href="/wiki/Vesicoureteral_reflux" title="Vesicoureteral reflux">vesicoureteral reflux</a>), which can be caused by some of the factors listed above as well as <a href="/wiki/Bladder_outlet_obstruction" title="Bladder outlet obstruction">compression of the bladder outlet</a> into the <a href="/wiki/Urethra" title="Urethra">urethra</a> by <a href="/wiki/Prostate_enlargement" class="mw-redirect" title="Prostate enlargement">prostate enlargement</a> or <a href="/wiki/Fecal_impaction" title="Fecal impaction">fecal impaction</a> in the <a href="/wiki/Rectum" title="Rectum">rectum</a> (which sits immediately behind the prostate), as well as abnormal contractions of bladder <a href="/wiki/Detrusor_muscle" title="Detrusor muscle">detrusor muscles</a> resulting from neurological dysfunction (<a href="/wiki/Neurogenic_bladder" class="mw-redirect" title="Neurogenic bladder">neurogenic bladder</a>) or other muscular disorders.<sup id="cite_ref-merck_2-1" class="reference"><a href="#cite_note-merck-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>==Pathophysiology== </p> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Medical_citations_needed plainlinks metadata ambox ambox-content" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/40px-Ambox_important.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/60px-Ambox_important.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/80px-Ambox_important.svg.png 2x" data-file-width="40" data-file-height="40" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>needs more <a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">reliable medical references</a> for <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">verification</a> or relies too heavily on <a href="/wiki/Wikipedia:Primary_sources" class="mw-redirect" title="Wikipedia:Primary sources">primary sources</a></b>.<span class="hide-when-compact"> Please review the contents of the section and <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hydronephrosis&action=edit">add the appropriate references</a> if you can. Unsourced or poorly sourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>. <small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Hydronephrosis%22">"Hydronephrosis"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Hydronephrosis%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Hydronephrosis%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Hydronephrosis%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Hydronephrosis%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Hydronephrosis%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">January 2020</span>)</i></span></div></td><td class="mbox-imageright"><div class="mbox-image-div"><span typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/52px-Star_of_life.svg.png" decoding="async" width="52" height="50" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/77px-Star_of_life.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/103px-Star_of_life.svg.png 2x" data-file-width="198" data-file-height="192" /></span></span></div></td></tr></tbody></table> <p>Hydronephrosis is caused by obstruction of urine before the renal pelvis. The obstruction causes dilation of the <a href="/wiki/Nephron" title="Nephron">nephron</a> tubules and flattening of the lining of the tubules within the kidneys which in turn causes swelling of the renal calyces.<sup id="cite_ref-:0_4-1" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Hydronephrosis can either be <a href="/wiki/Acute_(medicine)" title="Acute (medicine)">acute</a> or <a href="/wiki/Chronic_condition" title="Chronic condition">chronic</a>. In acute hydronephrosis, full recovery of kidney function is seen. However, with chronic hydronephrosis, permanent loss of kidney function is seen even once the obstruction is removed.<sup id="cite_ref-:0_4-2" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Obstruction that occurs anywhere along the upper urinary tract will lead to increased pressure within the structures of the kidney due to the inability to pass urine from the kidney to the bladder. Common causes of upper tract obstruction include obstructing stones and <a href="/wiki/Ureteropelvic_junction" class="mw-redirect" title="Ureteropelvic junction">ureteropelvic junction</a> (UPJ) obstruction caused by intrinsic narrowing of the ureters or an overlying vessel. </p><p>Obstruction occurring in the lower urinary tract can also cause this increased pressure through the reflux of urine into the kidney. Common causes include bladder dysfunction (such as <a href="/wiki/Neurogenic_bladder" class="mw-redirect" title="Neurogenic bladder">neurogenic bladder</a>) and urethral obstruction (such as posterior urethral valves in male infants) or compression (such as from <a href="/wiki/Benign_prostatic_hyperplasia" title="Benign prostatic hyperplasia">benign prostatic hyperplasia</a> in older male adults). </p><p>In pregnancy, dextrorotation (rotation to the right) of the uterus can cause compression on the right ureter, thus making hydronephrosis more common in the right kidney than in the left kidney. Besides, hormones such as estrogen, progesterone, and <a href="/wiki/Prostaglandin" title="Prostaglandin">prostaglandin</a> can cause ureter dilatation, thus causing hydronephrosis despite the absence of visible obstruction along the urinary tract. </p><p>To diagnose the disease, it is necessary to know the patient’s history as well as some other physical examination of the patient. This must be accompanied by some imaging tests. Usually, an ultrasonogram can be used to determine the condition of the patient’s urinary system, kidneys, etc. In addition, CT scans and MRIs can more clearly picture the urinary <a rel="nofollow" class="external text" href="https://www.healthpli.com/hydronephrosis-treatment-in-homeopathy/">tract and obstructions</a>. </p><p><sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=3" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Phydronephrosisfromstone.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Phydronephrosisfromstone.png/220px-Phydronephrosisfromstone.png" decoding="async" width="220" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Phydronephrosisfromstone.png/330px-Phydronephrosisfromstone.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Phydronephrosisfromstone.png/440px-Phydronephrosisfromstone.png 2x" data-file-width="1154" data-file-height="839" /></a><figcaption>Hydronephrosis due to a kidney stone at the ureteral vesicular junction seen on <a href="/wiki/CT_scan" title="CT scan">CT scan</a></figcaption></figure> <p>Prenatal diagnosis is possible,<sup id="cite_ref-pmid18520762_9-0" class="reference"><a href="#cite_note-pmid18520762-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> and in fact, most cases in pediatric patients are incidentally detected by routine screening ultrasounds obtained during pregnancy.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> However, approximately half of all prenatally identified hydronephrosis is transient, and resolves by the time the infant is born, and in another 15%, the hydronephrosis persists but is not associated with urinary tract obstruction (so-called non-refluxing, non-obstructive hydronephrosis). For these children, regression of the hydronephrosis occurs spontaneously, usually by age 3. However, in the remaining 35% of cases of prenatal hydronephrosis, a pathological condition can be identified postnatally.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>Diagnostic workup depends on the age of the patient, as well as whether the hydronephrosis was detected incidentally or prenatally or is associated with other symptoms. Blood tests (such measurement of creatinine) are typically indicated, though they must be interpreted cautiously. Even in cases of severe unilateral hydronephrosis, the overall kidney function may remain normal since the unaffected kidney will compensate for the obstructed kidney.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p><p>Urinalysis is usually performed to determine the presence of blood (which is typical for kidney stones) or signs of infection (such as a positive leukocyte esterase or nitrite). Impaired concentrating ability or elevated urine pH (distal renal tubular acidosis) are also commonly found due to tubular stress and injury.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Imaging_studies">Imaging studies</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=4" title="Edit section: Imaging studies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Renal_ultrasonography#Hydronephrosis" title="Renal ultrasonography">Renal ultrasonography § Hydronephrosis</a></div> <p>Imaging studies, such as an <a href="/wiki/Intravenous_urogram" class="mw-redirect" title="Intravenous urogram">intravenous urogram</a> (IVU), <a href="/wiki/Renal_ultrasonography" title="Renal ultrasonography">renal ultrasonography</a>, <a href="/wiki/CT_urogram" class="mw-redirect" title="CT urogram">CT</a>, or <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">MRI</a>, are also important investigations in determining the presence and/ or cause of hydronephrosis. Whilst ultrasound allows for visualisation of the ureters and kidneys (and determine the presence of hydronephrosis and / or hydroureter), an IVU is useful for assessing the anatomical location of the obstruction. <a href="/wiki/Pyelography" class="mw-redirect" title="Pyelography">Antegrade or retrograde pyelography</a> will show similar findings to an IVU but offer a therapeutic option as well. Real-time ultrasounds and <a href="/wiki/Doppler_ultrasound" class="mw-redirect" title="Doppler ultrasound">Doppler ultrasound</a> tests in association with <a href="/wiki/Vascular_resistance" title="Vascular resistance">vascular resistance</a> testing helps determine how a given obstruction is effecting urinary functionality in hydronephrotic patients.<sup id="cite_ref-Kay_12-0" class="reference"><a href="#cite_note-Kay-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>In determining the cause of hydronephrosis, the location of obstruction can be determined with a Whittaker (or pressure perfusion) test, wherein the collecting system of the kidney is accessed <a href="/wiki/Percutaneous" title="Percutaneous">percutaneously</a>, and the liquid is introduced at high pressure and constant rate of 10ml/min while measuring the pressure within the <a href="/wiki/Renal_pelvis" title="Renal pelvis">renal pelvis</a>. A rise in pressure above 22 cm H<small>2</small>O suggests that the urinary collection system is obstructed. When arriving at this pressure measurement, bladder pressure is subtracted from the initial reading of internal pressure. (The test was first described by Whittaker in 1973 to test the <a href="/wiki/Hypothesis" title="Hypothesis">hypothesis</a> that patients whose hydronephrosis persists after the <a href="/wiki/Posterior_urethral_valve" title="Posterior urethral valve">posterior urethral valves</a> have been <a href="/wiki/Ablation" title="Ablation">ablated</a> usually have ureters that are not obstructed, even though they may be <a href="/wiki/Dilation_(morphology)" title="Dilation (morphology)">dilated</a>.)<sup id="cite_ref-Kay_12-1" class="reference"><a href="#cite_note-Kay-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>Kay recommends that a <a href="/wiki/Neonate" class="mw-redirect" title="Neonate">neonate</a> born with untreated <a href="/wiki/Uterus" title="Uterus">in utero</a> hydronephrosis receive a renal ultrasound within two days of birth. A renal pelvis greater than 12 mm in a neonate is considered abnormal and suggests significant dilation and possible abnormalities such as obstruction or morphological abnormalities in the urinary tract.<sup id="cite_ref-Kay_12-2" class="reference"><a href="#cite_note-Kay-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>The choice of imaging depends on the clinical presentation (history, symptoms and examination findings). In the case of <a href="/wiki/Renal_colic" title="Renal colic">renal colic</a> (one sided loin pain usually accompanied by a trace of blood in the urine) the initial investigation is usually a spiral or helical CT scan. This has the advantage of showing whether there is any obstruction of flow of urine causing hydronephrosis as well as demonstrating the function of the other kidney. Many stones are not visible on plain <a href="/wiki/X-ray" title="X-ray">X-ray</a> or IVU but 99% of stones are visible on CT and therefore CT is becoming a common choice of initial investigation. CT is not used, however, when there is a reason to avoid radiation exposure, e.g. in pregnancy.<sup id="cite_ref-auto1_13-0" class="reference"><a href="#cite_note-auto1-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-auto_14-0" class="reference"><a href="#cite_note-auto-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>For incidentally detected prenatal hydronephrosis, the first study to obtain is a postnatal renal ultrasound, since as noted, many cases of prenatal hydronephrosis resolve spontaneously. This is generally done within the first few days after birth, although there is some risk that obtaining an imaging study this early may miss some cases of mild hydronephrosis due to the relative oliguria of a newborn. Thus, some experts recommend obtaining a follow-up ultrasound at 4–6 weeks to reduce the false-negative rate of the initial ultrasound.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> A <a href="/wiki/Voiding_cystourethrography" title="Voiding cystourethrography">voiding cystourethrogram</a> (VCUG) is also typically obtained to exclude the possibility of vesicoureteral reflux or anatomical abnormalities such as posterior urethral valves. Finally, if hydronephrosis is significant and obstruction is suspected, such as a ureteropelvic junction (UPJ) or ureterovesical junction (UVJ) obstruction, a nuclear imaging study such as a MAG-3 scan is warranted.<sup id="cite_ref-auto1_13-1" class="reference"><a href="#cite_note-auto1-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:BilateralHydroMark.png" class="mw-file-description" title="CT scan of bilateral hydronephrosis due to a bladder cancer"><img alt="CT scan of bilateral hydronephrosis due to a bladder cancer" src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cc/BilateralHydroMark.png/156px-BilateralHydroMark.png" decoding="async" width="156" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cc/BilateralHydroMark.png/234px-BilateralHydroMark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cc/BilateralHydroMark.png/312px-BilateralHydroMark.png 2x" data-file-width="1016" data-file-height="782" /></a></span></div> <div class="gallerytext"><a href="/wiki/CT_scan" title="CT scan">CT scan</a> of bilateral hydronephrosis due to a bladder cancer</div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Hydronephrosis.png" class="mw-file-description" title="Massive hydronephrosis as marked by the arrow"><img alt="Massive hydronephrosis as marked by the arrow" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Hydronephrosis.png/160px-Hydronephrosis.png" decoding="async" width="160" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Hydronephrosis.png/240px-Hydronephrosis.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Hydronephrosis.png/321px-Hydronephrosis.png 2x" data-file-width="1160" data-file-height="869" /></a></span></div> <div class="gallerytext">Massive hydronephrosis as marked by the arrow</div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/e/ea/UOTW_10_-_Ultrasound_of_the_Week_1.webm/180px--UOTW_10_-_Ultrasound_of_the_Week_1.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="180" height="107" data-durationhint="7" data-mwtitle="UOTW_10_-_Ultrasound_of_the_Week_1.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/e/ea/UOTW_10_-_Ultrasound_of_the_Week_1.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/ea/UOTW_10_-_Ultrasound_of_the_Week_1.webm/UOTW_10_-_Ultrasound_of_the_Week_1.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/ea/UOTW_10_-_Ultrasound_of_the_Week_1.webm/UOTW_10_-_Ultrasound_of_the_Week_1.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/ea/UOTW_10_-_Ultrasound_of_the_Week_1.webm/UOTW_10_-_Ultrasound_of_the_Week_1.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext"><a href="/wiki/Renal_ultrasonography" title="Renal ultrasonography">Renal ultrasonography</a> of hydronephrosis<sup id="cite_ref-UOTW10_16-0" class="reference"><a href="#cite_note-UOTW10-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><span><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/a/ab/UOTW_10_-_Ultrasound_of_the_Week_3.webm/180px--UOTW_10_-_Ultrasound_of_the_Week_3.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="180" height="107" data-durationhint="7" data-mwtitle="UOTW_10_-_Ultrasound_of_the_Week_3.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/a/ab/UOTW_10_-_Ultrasound_of_the_Week_3.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ab/UOTW_10_-_Ultrasound_of_the_Week_3.webm/UOTW_10_-_Ultrasound_of_the_Week_3.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ab/UOTW_10_-_Ultrasound_of_the_Week_3.webm/UOTW_10_-_Ultrasound_of_the_Week_3.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ab/UOTW_10_-_Ultrasound_of_the_Week_3.webm/UOTW_10_-_Ultrasound_of_the_Week_3.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext">Stone causing hydronephrosis<sup id="cite_ref-UOTW10_16-1" class="reference"><a href="#cite_note-UOTW10-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><span><video id="mwe_player_2" poster="//upload.wikimedia.org/wikipedia/commons/thumb/5/50/UOTW_10_-_Ultrasound_of_the_Week_2.webm/180px--UOTW_10_-_Ultrasound_of_the_Week_2.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="180" height="107" data-durationhint="7" data-mwtitle="UOTW_10_-_Ultrasound_of_the_Week_2.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/5/50/UOTW_10_-_Ultrasound_of_the_Week_2.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/50/UOTW_10_-_Ultrasound_of_the_Week_2.webm/UOTW_10_-_Ultrasound_of_the_Week_2.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/50/UOTW_10_-_Ultrasound_of_the_Week_2.webm/UOTW_10_-_Ultrasound_of_the_Week_2.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/50/UOTW_10_-_Ultrasound_of_the_Week_2.webm/UOTW_10_-_Ultrasound_of_the_Week_2.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext">Stone causing hydronephrosis<sup id="cite_ref-UOTW10_16-2" class="reference"><a href="#cite_note-UOTW10-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><span><video id="mwe_player_3" poster="//upload.wikimedia.org/wikipedia/commons/thumb/c/cf/UOTW_10_-_Ultrasound_of_the_Week_4.webm/180px--UOTW_10_-_Ultrasound_of_the_Week_4.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="180" height="107" data-durationhint="1" data-mwtitle="UOTW_10_-_Ultrasound_of_the_Week_4.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/c/cf/UOTW_10_-_Ultrasound_of_the_Week_4.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/c/cf/UOTW_10_-_Ultrasound_of_the_Week_4.webm/UOTW_10_-_Ultrasound_of_the_Week_4.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/c/cf/UOTW_10_-_Ultrasound_of_the_Week_4.webm/UOTW_10_-_Ultrasound_of_the_Week_4.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/c/cf/UOTW_10_-_Ultrasound_of_the_Week_4.webm/UOTW_10_-_Ultrasound_of_the_Week_4.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext">Urine jets<sup id="cite_ref-UOTW10_16-3" class="reference"><a href="#cite_note-UOTW10-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg" class="mw-file-description" title="Peripelvic renal cysts may look like hydronephrosis on non-contrast CT (left image). However, CT urography (at right) reveals non-dilated calyces and pelvises."><img alt="Peripelvic renal cysts may look like hydronephrosis on non-contrast CT (left image). However, CT urography (at right) reveals non-dilated calyces and pelvises." src="//upload.wikimedia.org/wikipedia/commons/thumb/4/42/CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg/180px-CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg" decoding="async" width="180" height="112" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/42/CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg/270px-CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/42/CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg/360px-CT_of_peripelvic_cysts_with_non-contrast_and_urography.jpg 2x" data-file-width="650" data-file-height="404" /></a></span></div> <div class="gallerytext">Peripelvic <a href="/wiki/Renal_cyst" title="Renal cyst">renal cysts</a> may look like hydronephrosis on non-contrast CT (left image). However, <a href="/wiki/CT_urography" class="mw-redirect" title="CT urography">CT urography</a> (at right) reveals non-dilated <a href="/wiki/Renal_calyx" title="Renal calyx">calyces</a> and <a href="/wiki/Renal_pelvis" title="Renal pelvis">pelvises</a>.</div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Grading">Grading</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=5" title="Edit section: Grading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File"><a href="/wiki/File:Society_for_Fetal_Urology_(SFU)_grading_of_hydronephrosis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg/150px-Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg" decoding="async" width="150" height="385" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/12/Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg/225px-Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/12/Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg/300px-Society_for_Fetal_Urology_%28SFU%29_grading_of_hydronephrosis.jpg 2x" data-file-width="312" data-file-height="800" /></a><figcaption></figcaption></figure> <p>The Society of Fetal Ultrasound (SFU) has developed a grading system for hydronephrosis, initially intended for use in neonatal and infant hydronephrosis, but it is now used for grading hydronephrosis in adults as well:<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Grade 0 – No renal pelvis dilation. This means an anteroposterior diameter of less than 4 mm in <a href="/wiki/Fetus" title="Fetus">fetuses</a> up to 32 weeks of <a href="/wiki/Gestational_age_(obstetrics)" class="mw-redirect" title="Gestational age (obstetrics)">gestational age</a> and 7 mm afterwards.<sup id="cite_ref-D'Addario2014_18-0" class="reference"><a href="#cite_note-D'Addario2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> In adults, <a href="/wiki/Cutoff_(reference_value)" class="mw-redirect" title="Cutoff (reference value)">cutoff values</a> for renal pelvic dilation have been defined differently by different sources, with anteroposterior diameters ranging between 10 and 20 mm.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> About 13% of normal healthy adults have a transverse pelvic diameter of over 10 mm.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li>Grade 1 (mild) – Mild renal pelvis dilation (anteroposterior diameter less than 10 mm in fetuses<sup id="cite_ref-D'Addario2014_18-1" class="reference"><a href="#cite_note-D'Addario2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup>) without dilation of the calyces nor parenchymal atrophy</li> <li>Grade 2 (mild) – Moderate renal pelvis dilation (between 10 and 15 mm in fetuses<sup id="cite_ref-D'Addario2014_18-2" class="reference"><a href="#cite_note-D'Addario2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup>), including a few calyces</li> <li>Grade 3 (moderate) – Renal pelvis dilation with all calyces uniformly dilated. Normal <a href="/wiki/Renal_parenchyma" class="mw-redirect" title="Renal parenchyma">renal parenchyma</a></li> <li>Grade 4 (severe) – As grade 3 but with thinning of the renal parenchyma</li></ul> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=6" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:LeftHydroPyloStentAcMark.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/87/LeftHydroPyloStentAcMark.png/220px-LeftHydroPyloStentAcMark.png" decoding="async" width="220" height="172" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/87/LeftHydroPyloStentAcMark.png/330px-LeftHydroPyloStentAcMark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/87/LeftHydroPyloStentAcMark.png/440px-LeftHydroPyloStentAcMark.png 2x" data-file-width="898" data-file-height="703" /></a><figcaption>Left sided hydronephrosis in a person with an atrophic right kidney. Stent is also present (image below).</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:LeftHydroPyloStentMark.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a8/LeftHydroPyloStentMark.png/220px-LeftHydroPyloStentMark.png" decoding="async" width="220" height="206" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a8/LeftHydroPyloStentMark.png/330px-LeftHydroPyloStentMark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a8/LeftHydroPyloStentMark.png/440px-LeftHydroPyloStentMark.png 2x" data-file-width="909" data-file-height="852" /></a><figcaption>Left sided hydronephrosis, coronal view. Stent is also present.</figcaption></figure> <p>Treatment of hydronephrosis focuses on the removal of the obstruction and drainage of the urine that has accumulated behind the obstruction. Therefore, the specific treatment depends upon where the obstruction lies.<sup id="cite_ref-auto_14-1" class="reference"><a href="#cite_note-auto-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Acute obstruction of the upper urinary tract is usually treated by the insertion of a <a href="/wiki/Nephrostomy" title="Nephrostomy">nephrostomy</a> tube. Chronic upper urinary tract obstruction is treated by the insertion of a <a href="/wiki/Ureteric_stent" class="mw-redirect" title="Ureteric stent">ureteric stent</a> or a <a href="/wiki/Pyeloplasty" title="Pyeloplasty">pyeloplasty</a>.<sup id="cite_ref-auto1_13-2" class="reference"><a href="#cite_note-auto1-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Lower urinary tract obstruction (such as that caused by bladder outflow obstruction secondary to benign prostatic hyperplasia) is usually treated by insertion of a <a href="/wiki/Urinary_catheter" class="mw-redirect" title="Urinary catheter">urinary catheter</a> or a <a href="/wiki/Suprapubic_catheter" class="mw-redirect" title="Suprapubic catheter">suprapubic catheter</a>. Surgery is not required in all prenatally detected cases.<sup id="cite_ref-pmid18947797_21-0" class="reference"><a href="#cite_note-pmid18947797-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=7" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The prognosis of hydronephrosis is extremely variable and depends on the condition leading to hydronephrosis, whether one (unilateral) or both (bilateral) kidneys are affected, the pre-existing kidney function, the duration of hydronephrosis (acute or chronic), and whether hydronephrosis occurred in developing or mature kidneys.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p><p>Permanent kidney damage can occur from prolonged hydronephrosis secondary to compression of kidney tissue and <a href="/wiki/Ischemia" title="Ischemia">ischemia</a>.<sup id="cite_ref-:0_4-3" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>For example, unilateral hydronephrosis caused by an obstructing stone will likely resolve when the stone passes, and the likelihood of recovery is excellent. Alternately, severe bilateral prenatal hydronephrosis (such as occurs with <a href="/wiki/Posterior_urethral_valve" title="Posterior urethral valve">posterior urethral valves</a>) will likely carry a poor long-term <a href="/wiki/Prognosis" title="Prognosis">prognosis</a>, because obstruction while the kidneys are developing causes permanent kidney damage even if the obstruction is relieved postnatal.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2021)">citation needed</span></a></i>]</sup> </p><p>Hydronephrosis can be a cause of <a href="/wiki/Pyonephrosis" title="Pyonephrosis">pyonephrosis</a>, which is a urological emergency.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div style="clear:both;" class=""></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hydronephrosis&action=edit&section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFMergenerWeinerthBaillie1997" class="citation journal cs1">Mergener K, Weinerth JL, Baillie J (December 1997). 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a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Kidney_disease" title="Template:Kidney disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Kidney_disease" title="Template talk:Kidney disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a 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href="/wiki/Renal_tubular_acidosis" title="Renal tubular acidosis">Renal tubular acidosis</a> <ul><li><a href="/wiki/Proximal_renal_tubular_acidosis" title="Proximal renal tubular acidosis">proximal</a></li> <li><a href="/wiki/Distal_renal_tubular_acidosis" title="Distal renal tubular acidosis">distal</a></li></ul></li> <li><a href="/wiki/Acute_tubular_necrosis" title="Acute tubular necrosis">Acute tubular necrosis</a></li> <li>Genetic <ul><li><a href="/wiki/Fanconi_syndrome" title="Fanconi syndrome">Fanconi syndrome</a></li> <li><a href="/wiki/Bartter_syndrome" title="Bartter syndrome">Bartter syndrome</a></li> <li><a href="/wiki/Gitelman_syndrome" title="Gitelman syndrome">Gitelman syndrome</a></li> <li><a href="/wiki/Liddle%27s_syndrome" title="Liddle's syndrome">Liddle's syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medullary_interstitium" class="mw-redirect" title="Medullary interstitium">Interstitium</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Interstitial_nephritis" title="Interstitial nephritis">Interstitial nephritis</a> <ul><li><a href="/wiki/Pyelonephritis" title="Pyelonephritis">Pyelonephritis</a></li> <li><a href="/wiki/Balkan_endemic_nephropathy" title="Balkan endemic nephropathy">Balkan endemic nephropathy</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Renal_artery_stenosis" title="Renal artery stenosis">Renal artery stenosis</a></li> <li><a href="/wiki/Renal_ischemia" class="mw-redirect" title="Renal ischemia">Renal ischemia</a></li> <li><a href="/wiki/Hypertensive_nephropathy" class="mw-redirect" title="Hypertensive nephropathy">Hypertensive nephropathy</a></li> <li><a href="/wiki/Renovascular_hypertension" title="Renovascular hypertension">Renovascular hypertension</a></li> <li><a href="/wiki/Renal_cortical_necrosis" title="Renal cortical necrosis">Renal cortical necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General syndromes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Nephritis" title="Nephritis">Nephritis</a></li> <li><a href="/wiki/Nephrosis" title="Nephrosis">Nephrosis</a></li> <li><a href="/wiki/Renal_failure" class="mw-redirect" title="Renal failure">Renal failure</a> <ul><li><a href="/wiki/Acute_kidney_injury" title="Acute kidney injury">Acute renal failure</a></li> <li><a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">Chronic kidney disease</a></li> <li><a href="/wiki/Uremia" title="Uremia">Uremia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Analgesic_nephropathy" title="Analgesic nephropathy">Analgesic nephropathy</a></li> <li><a href="/wiki/Renal_osteodystrophy" title="Renal osteodystrophy">Renal osteodystrophy</a></li> <li><a href="/wiki/Nephroptosis" title="Nephroptosis">Nephroptosis</a></li> <li><a href="/wiki/Abderhalden%E2%80%93Kaufmann%E2%80%93Lignac_syndrome" class="mw-redirect" title="Abderhalden–Kaufmann–Lignac syndrome">Abderhalden–Kaufmann–Lignac syndrome</a></li> <li><a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">Diabetes insipidus</a> <ul><li><a href="/wiki/Nephrogenic_diabetes_insipidus" title="Nephrogenic diabetes insipidus">Nephrogenic</a></li></ul></li> <li><a href="/wiki/Renal_papilla" class="mw-redirect" title="Renal papilla">Renal papilla</a> <ul><li><a href="/wiki/Renal_papillary_necrosis" title="Renal papillary necrosis">Renal papillary necrosis</a></li></ul></li> <li><a href="/wiki/Major_calyx" class="mw-redirect" title="Major calyx">Major calyx</a>/<a href="/wiki/Renal_pelvis" title="Renal pelvis">pelvis</a> <ul><li><a class="mw-selflink selflink">Hydronephrosis</a></li> <li><a href="/wiki/Pyonephrosis" title="Pyonephrosis">Pyonephrosis</a></li> <li><a href="/wiki/Reflux_nephropathy" title="Reflux nephropathy">Reflux nephropathy</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" 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