Nephroptosis

Description:

Nephroptosis (nephroptosis) - the morbid condition which is characterized by hypermotility of body therefore the kidney is displaced from the bed. Normal mobility of a kidney makes 1-2 cm, at forced ventilation, a natuzhivaniye - 3-5 cm, i.e. should not exceed length of a body of one vertebra. Exceeding of these parameters can be considered as pathological mobility. Normal the right kidney is below left on 2 cm, only in 5,5% the left kidney is lower than right. At children of a kidney are located below, than at adults, and adopt the usual provision by 8-10 years.

The disease is more often observed at women (a ratio of women and men 10:1) and, as a rule, on the right.

Nephroptosis symptoms:

Moderately expressed nephroptosis which is not followed by disturbances uro-and a hemodynamics, proceeds almost asymptomatically. The most frequent symptom of a disease is the stupid, aching pain amplifying after an exercise stress and in vertical position of a body. Chronic pyelonephritis quite often accompanies a nephroptosis and develops against the background of chronic disturbance haemo - and urodynamic of a kidney that leads to development of favorable conditions for emergence and development of a chronic inflammation. Progressing, pyelonephritis considerably burdens a current of a nephroptosis.

The hamaturia (macro, micro) is rather often observed at a nephroptosis, develops as a result of disturbance of a renal blood-groove, venous hypertensia, a phlebostasia.

Arterial hypertension at a nephroptosis has the renovascular nature.

At permanent disturbances of urodynamic of upper uric ways there is a hydronephrotic transformation. This state is especially characteristic for is long the existing nephroptosis with the fixed ureter excesses.

Nephroptosis reasons:

Emergence of a nephroptosis is connected with the pathogenetic factors leading to changes of the copular device of a kidney. Carry to the structures creating the fixing kidney device: peritoneal sheaves, the renal bed formed by fastion, a diaphragm, muscles of an abdominal wall and a waist, own fascial and fatty device. In fixing of a kidney the adipose capsule which reduction can result in hyper mobility of a kidney has a certain value. The correct position of a kidney is supported also by vessels of a renal leg.

Many authors consider one of the main reasons for formation of a nephroptosis weakness of connecting fabric and, as a result, the copular device. Often these patients in addition to a nephroptosis have hyper mobility of joints, short-sightedness, a visceroptosis, etc. It should be noted that only one hyper mobility of a kidney without clinical symptomatology is not a disease.

Treatment of the Nephroptosis:

The most part of patients concerning a nephroptosis does not need an operative measure, they receive conservative treatment. The main treatment is presented by a complex of the physical exercises directed to strengthening of muscles of a front abdominal wall and a waist. Patients are limited concerning exercise stresses.

Indications to surgical treatment of a nephroptosis are: pyelonephritis resistant to treatment, the arterial hypertension, renal bleedings caused expressed flebostatozy, a hydronephrosis, a secondary nephrolithiasis, a megalgia. As contraindications to operation serve the splanchnoptosia, a heavy intercurrent background, teenage or advanced age of patients.