Introduction
Kidney enlargement can develop at any age and affects the kidneys of prenatal infants as well as adults and children. This swelling occurs when the ureters that drain the kidneys become blocked, causing a pool of urine that causes the kidneys to enlarge. The enlargement of the kidney is often accompanied by an underlying health condition.
What Is Nephromegaly?
Enlarged kidneys are relatively rare, and only a few specific diseases lead to this condition. The kidneys filter the harmful metabolites from the blood and ensure adequate conditions to maintain blood pressure. Enlarged kidneys can affect overall function.
What Are the Causes of Nephromegaly?
1. Hydronephrosis: It is a blockage of urine flow and leads to swelling of the kidneys. The condition can be caused by kidney stones, blood clots, an enlarged prostate, fecal blockage, injury, infection, radiation, and even tumors. Pregnant women can also develop hydronephrosis. It is because the expanding uterus creates pressure that impedes urine flow. The symptoms of this condition are excruciating intermittent flank pain, while the chronic form of hydronephrosis may have no symptoms at all. Treatment often involves removing the cause of the obstruction. It includes.
2. Polycystic Kidney Disease: A condition characterized by the accumulation of fluid-filled sacs called cysts in the kidneys. Cysts can also be found elsewhere in the body. Complications of polycystic kidney disease include hypertension, pain, urinary tract infections, liver cysts, and renal failure due to progressive loss of function.
3. Pyelonephritis: An infection of the kidney that originally resulted from a bladder infection or a blood-borne infection. People with diabetes, pregnant women, and immunocompromised individuals are considered high-risk patients. Signs and symptoms include enlarged kidneys, tenderness on one or both sides of the lower back, fever, chills, frequent and painful urination, foul-smelling or cloudy urine, and cramps that cause severe pain. Treatment includes the use of antibiotics to eradicate the infection.
4. Renal Cell Carcinoma: Kidney cancer, one possible cause of kidney enlargement, can spread to the small tubules of the kidney that filter blood. Over time, this can lead to enlarged kidneys if not treated properly.
5. Perinephric Abscess: It usually results from acute pyelonephritis but can also be caused by the rupture of a renal abscess into the perineal space. Perinephric abscesses are common in people with diabetes, kidney stones, and patients with septic embolisms.
What Are the Symptoms of Nephromegaly?
Signs and symptoms of Nephromegaly include:
1. Pain: Burning pain during urination may be associated with enlarged kidneys. This may mean a urinary tract infection may be a precursor for kidney enlargement. Pain is usually localized near the pelvis, above the bladder, or near the lower abdomen. Women generally feel pain near the vaginal opening, while men feel pain at the end of the urethra. The pain may also move to the lower back or radiate. Patients may experience nausea and vomiting as the kidney crust swells. Enlarged kidneys from kidney stones can cause severe pain lasting 20 to 30 minutes.
2. Swelling: It commonly occurs in the legs of affected patients and is caused by the inability of fluid to flow properly through the diseased kidney. It is also a sign of heart failure.
3. Changes in Urination: Since the kidneys are directly involved in urine production, abnormal changes in voiding patterns may indicate enlarged kidneys. Drinking large amounts of fluids, caffeine, or alcohol can increase the frequency of urination, but kidney enlargement manifests itself in more unusual ways. Chronic metabolic diseases such as diabetes can lead to kidney damage and renal hypertrophy. Hematuria also indicates a problem with the kidney system.
When to Get Help?
A physician’s appointment should be sought right away if any symptoms of nephromegaly are noticed.
How Is Nephromegaly Diagnosed?
Nephromegaly can be identified by testing the following parameters during routine check-ups or appointments for the treatment of other chronic conditions:
1. Physical Examination of the Abdomen - The physician may palpate the lower abdomen and feel the presence of swollen kidneys.
2. Urinalysis - This may show signs of decreased kidney function, such as red blood cells, white blood cells, and proteins that should not be present in urine; these are signs of underlying inflammation.
3. Blood Test - Analysis of blood samples reveals higher levels of waste products in the bloodstream, the presence of antibodies that may indicate an autoimmune disease, bacterial or viral infections, or blood sugar levels that indicate diabetes.
4. Imaging Test - If the physician finds signs of nephromegaly, they may recommend imaging tests. Imaging tests may show a difference in the shape and size of the kidneys. These tests include X-rays, ultrasounds, or CT (computed tomography) scans.
If necessary, the doctor may recommend additional imaging tests like the MAG3 (mercaptoacetyltriglycine) scan, which assesses kidney function and excretion.
What Is the Treatment of Nephromegaly?
Treatment of nephromegaly often involves identifying and treating the underlying condition.
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Removing the obstruction to the urine flow is usually a priority if the kidney is enlarged due to a blockage such as hydronephrosis. Depending on the cause of the blockage, physicians choose the best option to ease the condition. It may involve inserting a ureteral stent, a tube that drains the ureter into the bladder, or a nephrostomy tube that drains obstructed urine out the back.
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Infections that cause pyelonephritis are often treated with bacteria-specific antibiotics. Depending on how severe the condition is, treatment can be given orally or intravenously. Commonly used antibiotics are Trimethoprim with Sulfamethoxazole, Ciprofloxacin, and Levofloxacin, depending on the history of allergy and infection. Treatment cycles last 10 to 14 days.
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Polycystic kidney disease cases are generally hereditary and rarely lead to serious kidney problems. Treatment includes prescription pain relievers, blood pressure medications, antibiotics for urinary tract infections, a low-sodium diet, and diuretics to remove excess water from the body.
How to Prevent Nephromegaly?
Nephromegaly can be prevented in some cases. Here are some steps that may be beneficial:
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Keeping water intake regular throughout the day.
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Frequent urination.
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Getting regular body check-ups.
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Eating a balanced diet.
Conclusion:
Nephromegaly is a condition resulting from underlying issues that must be considered. An increase in the size may indicate the presence of an infection, blockage, or congenital deformity. Proper care and medication should be taken to prevent long-term kidney damage.
