Kidney prolapse: causes, treatment and prevention of nephroptosis. Mobile kidney in a child Nephroptosis of the right kidney in children

25.03.2016

The kidney, like other human organs, is fixed inside the body. In this particular case, the attachment occurs using the renal pedicle and bed, and the kidney shell itself is attached to the side of the spine.

Nephroptosis is a prolapse of the kidney, in which the organ is displaced more than two vertebrae down from its normal position. If the right kidney is lowered, then in some cases it may not return to its original position.

Causes of kidney prolapse

There are various causes, as well as stages of kidney prolapse. Before you start treatment, make sure your symptoms match. So, the symptoms causing kidney prolapse:

unexpected weight loss;
lumbar injuries with the occurrence of a hematoma in the kidney area;
heavy physical labor, consisting of lifting weights (especially for women);
infectious kidney diseases.

Symptoms of kidney prolapse in women appear more often than in men, and, accordingly, more serious consequences. The reasons lie in more elastic connective tissue, as well as weak abdominal muscles.

Types of kidney prolapse

There are different degrees and stages of kidney prolapse. Depending on the degree of kidney mobility, the following should be distinguished:

fixing;
mobile appearance of a drooping kidney (this pathology is also called a wandering kidney).

There are three stages of development of the fixing type. Their symptoms are:

symptoms of the first stage - the lower part of the kidney leaves the hypochondrium during inhalation, and when exhaling it returns to its original position. A similar movement occurs when a person’s body suddenly changes from horizontal to vertical. Treatment in this case will be the most effective;
symptoms of the second stage - the kidney moves to the pelvic region. As a result of increased pressure in the renal vessels, protein and red blood cells are present in the urine. This period is quite painful, the patient may have symptoms such as colic and a dull aching pain. In this case, you need to start treatment immediately, as the consequences can be very negative;
symptoms of the third stage are stretching of the renal pedicle and its further twisting. Consequences can manifest themselves in the form of difficulty in excreting urine and the occurrence of infectious complications.

Symptoms of a prolapsed kidney

Symptoms of kidney prolapse directly depend on the degree of neglect of the process. In the first degree, a person may not suspect that treatment is required. The initial stages are not always accompanied by painful processes and changes in biochemical blood parameters. In some cases, the causes of this phenomenon can provoke pain in the lumbar region, which quickly passes. If pain occurs rarely, it is difficult to determine its cause and prescribe appropriate treatment.

At the onset of the second degree of prolapse, aching constant pain occurs, which becomes quite strong, it deprives a person of the ability to work, leads to loss of appetite and a depressive state.

Dangers of kidney prolapse

If appropriate treatment is not prescribed, especially with the last degree of kidney prolapse, this can lead to the following consequences:

Lack of treatment leads to hydronephrosis, pyelonephritis and urolithiasis. In this case, no special symptoms may be observed, but the process will already have started, and over time it will be too late to do anything;
a moving kidney can cause termination of pregnancy - miscarriage;
loss of ability to work;
stroke and arterial hypertension.

Treatment of kidney prolapse

What to do after you have determined the causes and degrees of kidney prolapse? Of course, start timely treatment, and you can choose what to do: use folk or traditional methods.

Treatment consists of no shaking, heavy physical activity, or jumping. What to do to ease the load on the kidneys? Reduce your consumption of meat and salt, you can follow a special diet for your kidneys, which should be prescribed by your doctor.

If there are no indications for surgical intervention, then the kidney can be fixed; in this case, it is recommended to use special lumbar bondage. It is recommended to put it on only in a supine position, tightening it while inhaling, otherwise the reasons for non-compliance with the rules may lead to a worsening of the condition. If the patient is underweight, then it is necessary to adhere to a special diet. Increasing the volume of the fat layer will allow you to cope with the disease faster.

You can use various painkillers, antispasmodics, take warm baths and sleep with your legs slightly elevated. One of the most important elements in the treatment of such a disease is LCF. This exercise will allow you to fix the kidney in one position, eliminating the possibility of its further prolapse.

If kidney prolapse occurs below the 4th lumbar vertebra, then surgical intervention is necessary. Also, indications for surgery may include severe pain, irreversible impairment of kidney function, and increased blood pressure in the renal system.

Traditional methods of treatment

Traditional methods will be effective only if there is no need for surgical intervention. Such methods can be an excellent prevention of complications, reducing pain symptoms, but they will not be able to return a prolapsed kidney to its previous state. So, here are some of the most effective recipes for treating a prolapsed kidney at home:

Sunflower seeds, pumpkin seeds, flax seeds and any nuts can be beneficial. Flaxseeds should be washed with clean drinking water, sprinkled with powdered sugar and fried in a dry frying pan. Take orally three times a day, a teaspoon, chewing well;
Grind the stems of Kochia broom and pour boiling water in a ratio of 1:3. Brew the resulting mixture for about 12 hours, then strain thoroughly. Drink the resulting liquid three times a day, a quarter of a tablespoon;
Now let's move on to taking healing baths. Chop oats and straw, mixing with water in a ratio of 1:20. The resulting mixture should be boiled over low heat for about an hour, then allowed to brew for several hours. The resulting solution should be used in its pure form for taking a bath;
pour boiling water over a mixture of flax seeds, echinacea flowers, rosehip petals, and knotweed and leave for about 15 minutes. Take three times a day for one month.

Physical exercises for kidney prolapse

The basis for the cure for nephroptosis is special gymnastics. There are a number of specific exercises that should be done at least once a day. The proposed complex allows you to strengthen the muscles of the lower back and abdomen, while stabilizing the position of the kidney in the peritoneum.

"martin". Starting position: lying on your stomach, legs together, straightened, arms extended to the sides, palms down. At the same time, we lift our arms, head, straight legs and chest off the floor as much as possible. We hold this position for 1–3 seconds, then lower ourselves. You need to do the exercise without jerking, smoothly. It is recommended to do 10–15 repetitions. If your physical fitness is weak, you can only lift your legs, arms and head. Important: legs should not be bent at the knees;
Starting position: lie on your back, arms lie along your body, palms down. Without bending the knees, we lift each leg in turn. Repeat 10 times for each leg;
lie on your back, pull your legs towards your stomach, bending your knees. Repeat at least 10 times. There is a simpler option - an identical exercise, but perform it for each leg in turn;
lying on your left and then on your right side, raise your straight leg as high as possible, repeat 8–10 times;
for the exercise you will need a small ball: in a lying position, you should squeeze the ball between your legs above your knees, holding it in a compressed position for 8-10 seconds. Repeat several times.

Depending on your physical fitness and health status, you can expand the set of exercises. It must be remembered that first of all you should pay attention to the oblique, lateral, rectus abdominis muscles and the muscle that straightens the spine. These muscles make it possible to achieve a powerful frame that will protect against prolapse of the kidneys, stabilizing its position.

Prevention of kidney prolapse

Sport will be an excellent prevention of kidney prolapse. Morning daily exercises, so-called exercises, can strengthen the muscles of the whole body, helping them better cope with heavy unexpected loads. In addition to such exercises, you can also use evening or morning jogging, cycling, swimming in the pool, as well as other types of active lifestyle.

It is recommended to pay special attention to the lumbar region, since strong abs are a reliable guarantee against pinched spinal nerves, prolapse of the kidneys and protrusions of the intervertebral discs. A person should not be afraid of regular exercise, because this will protect him from possible kidney prolapse when lifting weights.

People with the first stage of nephroptosis are recommended to visit a nephrologist at least once a year, take urine tests and undergo an ultrasound of the kidneys. This will allow you to adjust treatment in a timely manner, preventing the subsequent development of the disease.

Prolapse of the kidneys is called nephroptosis. This is a pathology in which these organs have excessive mobility. Normally, the kidneys can move 1-2 cm up or down. This happens when the body position changes, as well as when breathing. With nephroptosis in a vertical position, the kidney descends into the abdominal cavity, and in severe cases, even into the pelvis (vagus organ).

Etiology

The kidneys are held in the appropriate position with the help of special ligaments. When they are weakened, these organs can move much more than what happens when everything is normal.

If kidney prolapse develops, the causes of this pathology may be the following:

sudden weight loss, which leads to a decrease in the fat capsule;
hereditary excessive extensibility of connective fibers (for example, with Ehlers-Danlos syndrome);
sudden lifting of a load or injury in the lumbar region, which leads to damage to the ligamentous apparatus;
formation of hematoma in the perinephric tissue;
when kidney prolapse is observed, the causes of this disease may include abdominal pain, which, for example, happens during pregnancy;
heavy physical activity;
infectious

Clinic. Features of pain syndrome in nephroptosis

Initially, there are no clinical manifestations. Subsequently, discomfort appears in the lumbar region. At first, the pain is pulling or aching, less often - stabbing in nature, quickly disappears, and is not pronounced. Then it becomes more intense, constant, and exhausts the patient.

Pain during kidney prolapse first occurs after physical exertion, severe coughing or due to lifting loads and decreases in a supine position. It should be noted that their localization is quite different - not only in the kidney area, but also in the back, abdomen, and under the shoulder blade. This is due to the fact that the displaced kidney compresses neighboring organs. Sometimes pain with nephroptosis imitates renal colic and is characterized by irradiation to the genitals or groin area. During a painful attack, nausea and vomiting and fever may occur.

Patients also experience decreased appetite, constipation or diarrhea, functional disorders of the nervous system (neurasthenia, increased excitability), dizziness, insomnia and palpitations.

Degrees of nephroptosis

There are the following degrees of kidney prolapse:

First, the kidney can be felt when inhaling through the anterior abdominal wall. In this case, the patient may experience aching pain in the lower back, which disappears when lying down. During exhalation, it moves to the hypochondrium. It should be noted that the kidney can only be palpated in very thin people; in all others it is not palpable.

Second degree - in the vertical position of the patient, the kidney completely leaves the hypochondrium, but when lying down it returns to its place. It can be straightened by hand without pain. At this stage of the disease, pain in the lower back becomes more intense and spreads to the abdominal area. They intensify with physical activity and disappear if the patient lies down.

Third, the kidney in any position emerges from the hypochondrium and can descend into the pelvis. Patients complain of constant abdominal pain, which can radiate to the lumbar region. Blood appears in the urine after exercise.

Complications

It should be noted that nephroptosis is a pathological process that leads to serious consequences. With a significant displacement of the kidneys, the ureter becomes twisted and bent, as a result of which the normal outflow of urine is disrupted. This leads to expansion of the pelvis and provokes hydronephrotic transformation.

In most cases, stagnation of urine causes pyelonephritis. Urolithiasis and hematuria (the appearance of blood in the urine) may also occur. In addition, nephroptosis can provoke spontaneous miscarriages, lead to stroke and complete disability, so timely consultation with a doctor is the key to preventing a number of pathological conditions, which in some cases pose a threat to life.

When kidney prolapse develops, the consequences of this pathology may include arterial hypertension, which is associated with impaired blood supply to the diseased organ.

Conservative therapy

Treatment for kidney prolapse depends on the severity of the disease. At the initial stages, orthopedic techniques are effective. Patients are asked to wear special bandages, which are made individually for each patient. It should be noted that they need to be put on while lying down and tightened while exhaling. A contraindication to such therapy is fixation of a prolapsed kidney with adhesions.

If the cause of the pathology is a sharp weight loss, then treatment of kidney prolapse must include an appropriate diet, the purpose of which is to increase the perinephric fat layer. Patients are also advised to limit salt and meat in their diet to reduce the load on the diseased organ.

To eliminate pain, patients are prescribed antispasmodics and painkillers. Warm baths and standing with your legs elevated have a positive effect. If kidney inflammation develops, antibiotic therapy is included in complex treatment.

It is important to strengthen the muscle fibers of the abdominals and back. For this purpose, massage courses are prescribed, as well as therapeutic exercises. At the first stage of kidney prolapse, sanatorium treatment and limitation of physical activity and jumping are recommended.

Exercises to correct nephroptosis

A set of special exercises should be performed in the morning (on an empty stomach and on a soft mat). It is recommended to drink warm water before classes. The duration of the exercises should be at least 30 minutes.

1. You need to lie on your back with your knees bent. When inhaling, you should inflate your stomach, holding your breath, and draw it in when exhaling.

2. Take the previous starting position. When inhaling, raise the outstretched leg vertically; when exhaling, lower it.

3. Lie on your back and raise your legs, keeping your knees together. Inhale and spread your limbs, and as you exhale cross them.

4. Lie on your back and place a cushion under your lower back (you can use a pillow). As you inhale, bend your right leg, as you exhale, lower it. Repeat the exercise with your left leg.

5. Lie on your back, place your arms along your body, bend your legs at the knees (feet should be on the floor), alternately lift your left and then your right leg.

6. In a lying position, bend your lower limbs at the knees, place a ball between them and squeeze it for a few seconds, repeating 4-5 times.

When performed correctly, this gives a good therapeutic effect.

Surgical therapy

Indicated for severe pain that leads to disability, chronic pyelonephritis with frequent exacerbations, as well as significant loss. Surgical treatment of renal prolapse is also used for orthostatic hypertension, hydronephrosis and bleeding.

If nephroptosis is accompanied by severe inflammation in the kidneys, antibiotic therapy is first performed. A few days before surgery, patients should sleep with their legs elevated. This helps return the prolapsed kidney to its normal position and facilitates surgical intervention.

The essence of surgical treatment is to fix the kidneys to the muscles of the abdominal wall. It should be noted that there are several surgical techniques if kidney prolapse is diagnosed. The causes of this pathology, the peculiarities of its course and the presence of certain complications influence the method by which the surgeon will perform the surgical intervention.

Traditional methods of treating nephroptosis

Traditional medicine methods can only prevent the progression of the disease and reduce the manifestations of pain. They cannot return the affected organ to its previous state.

Kidney prolapse develops. What to do? You should first consult your doctor. He will determine the most optimal therapeutic tactics and the possibility of using one or another traditional treatment method.

As a rule, to improve the functioning of affected kidneys, it is recommended to rinse the flax seeds with water, sprinkle them with powdered sugar and fry them in a dry frying pan, then take 1 teaspoon three times a day, chewing well. You can also brew the stems of Kochia broom and take the resulting liquid before meals. A positive effect for nephroptosis is obtained by using an infusion of knotweed, rosehip leaves and echinacea flowers for a month, as well as taking baths in a decoction of straw and oats.

If the patient's condition does not improve, therapeutic tactics should be changed.

Prevention of nephroptosis

Treatment of kidney prolapse is much more difficult than its prevention:

It is necessary from childhood to monitor posture and prevent spinal deformities;

If you need to carry a load, you should distribute it evenly between two hands.

With an asthenic type of structure, strength exercises are contraindicated.

Excessive physical activity, forced posture, prolonged standing or sitting, and exposure to vibration should be avoided.

During pregnancy, you need to wear a prenatal bandage.

You cannot drive yourself to the point of asthenia with exhausting diets.

It is necessary to protect yourself from injuries, especially in the lumbar region.

You need to strengthen your abdominal muscles. To do this, you should regularly perform

If you experience any discomfort or nagging pain in the lower back, you should immediately consult a doctor, take the appropriate tests or undergo the necessary instrumental examinations. It is worth remembering that self-medication can lead to a number of serious kidney diseases or even loss of the affected organ.

Kidney prolapse in a child is a fairly common diagnosis in pediatrics. What is the essence of nephroptosis and how to deal with it?

What is kidney prolapse?

In medical practice, the phenomenon of kidney prolapse is called nephroptosis. With it, kidney mobility exceeds the physiological norm. In the absence of pathologies, this organ, during breathing and changing body position, can move vertically from the area of the renal bed by a maximum of 2-3 cm. If a child has prolapse, the kidney moves by 6-8, and sometimes by 10 cm. There are situations when it falls into the pelvic cavity. Popularly, such a mobile organ is often called vagus.

The organ is held in its correct position by structures such as fascia and ligaments. They form the renal bed and fascial fat capsule, fatty tissue between the kidneys and adrenal glands, regulate intra-abdominal pressure (it is created by the diaphragm and the anterior abdominal wall),

Doctors distinguish several stages of kidney prolapse. There are three of them:

The first stage - the prolapsed organ can be felt through the abdominal wall during inhalation. When you exhale, the kidney returns back under the costal edge and it is no longer possible to palpate it.
The second stage - the kidney can be completely palpated slightly below the hypochondrium line if the patient is in an upright position. When the patient lies down, the kidney is located in the hypochondrium.
The third stage - regardless of the position of the body, the kidney completely emerges from the hypochondrium area. In advanced cases, the organ sinks into the pelvis.

Mixing of the kidneys can occur vertically and rotationally (moves in a circle), pendulum-like or around the renal pedicle. During the transition to more severe stages, the main vessels of the organ (arteries and veins) can twist and stretch. When this happens, the diameter of these vessels decreases.

Due to such processes, the blood supply to the renal structures is disrupted, hypoxia occurs, lymphatic drainage is disrupted and venous pressure increases. Pathologies in lympho- and hemodynamics are fraught with the development of chronic pyelonephritis.

When stage 3 nephroptosis occurs, the ureter becomes bent. Because of this, the pelvis in the kidneys begins to expand and problems arise with urine excretion. First, inflammatory processes occur in the kidneys, which then develop into adhesive processes (perinephritis occurs). Adhesive formations fix the organ in an incorrect position.

Most often, kidney prolapse is diagnosed in girls. The right kidney is mainly affected. This is due to the fact that the left kidney has a strong ligamentous apparatus. In addition, the right kidney is normally located slightly lower. Some babies have bilateral ptosis, called ptosis.

Symptoms

The clinical picture can be of a different nature: complicated nephroptosis, clinically manifest and asymptomatic. There are common symptoms that are observed in almost all patients:

Pain. It is paroxysmal and dull in nature, localized mainly in the hypochondrium, abdomen (radiating to the back) and lower back. The intensity of this symptom increases when the child moves, coughs, and plays sports.
Urinary incontinence at night and during the day.
Problems with appetite and other bowel dysfunction. This occurs due to the course of general pathological processes in the body.
Increased pressure. Occurs due to the entry into the blood of angiotensin, which is synthesized during vascular spasms.
Severe swelling. Mostly the area under the eyes swells. Swelling becomes especially severe if the baby drinks a lot of liquid.
Renal colic. The processes inside the kidney are disrupted and severe spasms occur.
Nausea and vomiting. Appear at the extreme stages of the disease.
Blood and traces of protein in the urine.

If the child’s condition is very advanced, he develops psycho-emotional disorders - neurasthenia, depressive states, increased excitability. This situation is characterized by respiratory failure.

Please note: in the absence of proper treatment for nephroptosis, toxic substances will begin to accumulate in the child’s blood plasma fluid, which can lead to brain damage brain

Kidney prolapse in a child - causes and consequences

There are many reasons for this phenomenon, but most often nephroptosis occurs due to:

Kidney diseases caused by infection - rickets, bronchitis, tonsillitis. With them, deformation of the spine often occurs.
Excessively intense physical activity or heavy lifting.
Congenital anomalies in skeletal development. This means inadequate development or absence of the lower ribs.
Anatomical features of the child. Due to age-related body imbalances, the baby’s muscle tissue develops unevenly.
Rapid and significant loss of body weight, due to which the fat capsule around the kidneys becomes thinner.
Predisposition to stretching of connective tissues (for example, Ehlers-Danlos syndrome).
Injury to the lumbar region with subsequent damage to the ligamentous apparatus and the appearance of hematomas in the perinephric tissue.

Children with poor tone of the muscles located in the anterior abdominal wall, an asthenic physique and poorly developed subcutaneous fat are susceptible to kidney prolapse.

The process of kidney prolapse itself does not have a pronounced clinical picture until changes in hemodynamics and urine output begin. At the same time, already at the initial stages of the disease, pathological processes of structural damage to the renal tissue begin. This phenomenon can cause the patient:

pyelonephritis – inflammation of the kidneys;
myocardial infarction and stroke - due to changes in blood circulation and increased arterial and venous pressure;
urolithiasis - difficulty draining urine stimulates the development of infections in the kidneys, as a result of which stones can form in the renal pelvis.

Diagnosis of the disease

Since the initial stages of nephroptosis have virtually no pronounced symptoms, it is almost always discovered by chance. To fully diagnose the disease, the following methods are used:

taking an anamnesis - the patient is questioned about complaints, previous injuries and diseases;
palpation (palpation) of the abdomen, sides and back;
various x-ray examinations (radiography of the kidneys and excretory urography);
ultrasound examination of the kidneys (lying and standing);
laboratory tests of urine and blood (they also help to identify possible complications);
renography (to study the completeness of kidney functionality);
radioisotope scanning or scintigraphy to further clarify the position of the kidney.

How is the pathology treated?

Kidney prolapse is treated comprehensively. The following activities are used:

diet
orthopedic treatment
belly massage
therapeutic exercises

Feeding a child with kidney prolapse

It should not put extra strain on the kidneys or irritate them. The baby should eat up to 6 times a day, portions should be small. The lion's share of the diet consists of fruits and vegetables, consumed boiled, baked or raw. Seafood dishes will be very healthy. It is important that the child drinks a sufficient amount of ordinary water - at least 1.5 liters.

The red list includes strong broths, pickles, all canned foods, legumes, sweets, soda, and sweets. If a patient has developed chronic renal failure, it is necessary to constantly monitor the amount of protein consumed per day (up to 25 g). There are a lot of them in cereals, beans and flour. Many metabolic products are released from them, which are excreted by the kidneys and thereby load them.

You should also not consume a lot of phosphorus and salt. They are found in nuts and cocoa. Sodium-containing foods should also be limited, because they stimulate increased blood pressure and retain fluid in the body.

Orthopedics

To support the muscles, you can wear special bandages. They are put on in the morning and worn throughout the day. It is important that a specialist selects a belt for the child and that he explains the technology for putting it on.

Exercises

They are effective only in the initial stages of dysfunction. Performed daily, the lesson lasts at least half an hour. All exercises are performed lying on your back. To make it easier to do them, place a soft towel cushion under the child’s lower back.

Bend your knees. As you inhale, stick your stomach out and exhale, draw it in. 10-15 repetitions are done.
Raising straight legs 5 times each.
Pulling the bent leg towards the stomach, 5 times each leg.
Exercise “bicycle”, done for about 3 minutes.
Bringing your knees together with a ball between them. Up to 5 reps.
As you inhale, raise your outstretched legs, and as you exhale, lower them. Up to 10 times.
Heels and knees together, lifting straight legs up. On inhalation, separate them; on exhalation, cross them. Up to 10 repetitions.

You cannot run, stretch, jump or hang on horizontal bars and parallel bars.

Other treatments for nephroptosis

Treatment with medications is used only when the child already has some complications. These include kidney stones, pyelonephritis and arterial hypertension. In cases where conservative treatment methods do not help a small patient, surgical intervention is used. Main indications for surgery:

persistent pain;
recurrent or chronic pyelonephritis;
orthostatic hypertension;
loss of any physical activity;
hydronephrosis.

The intervention is aimed at artificial fixation of the kidney. Most likely, the child will undergo surgery via laparoscopy. This is the best option, because the method is almost non-traumatic, the risk of complications is minimal, blood loss is also minimal, and the recovery period is easy.

Conclusion

Symptoms of kidney disease in a child should be treated very carefully, because they may indicate nephroptosis. This disease is very dangerous for the baby and can cause a number of complications due to which the kidney will not function properly throughout its life.

Multi-stage diagnosis and comprehensive treatment will help get rid of the pathology. To detect kidney prolapse in a timely manner, regularly take your baby for examinations to the pediatrician. Be healthy!

Kidneys are paired formations that perform in the body the function of purifying the blood and removing harmful breakdown products of proteins, fats and carbohydrates. Normally, they are located at the level of the last thoracic and first lumbar vertebrae, with the right organ located slightly lower than the left, which causes its greater damage. Every year, at least fifteen thousand people around the globe suffer from kidney prolapse: the disease occurs in both children and people of mature working age. That is why it is so necessary to know how to properly deal with the disease and which doctor to seek advice and medical help in case of primary manifestations.

What is kidney prolapse

Kidney prolapse, which is scientifically called nephroptosis, is a pronounced downward displacement of the organ from its original position. It can be either unilateral or bilateral. This disease most often occurs in pregnant women, children under 10 years of age, and thin teenagers and young adults. Elderly people, due to wear and tear of the muscular frame, are also susceptible to the formation of a similar disease.

The terms nephroptosis and wandering kidney should not be confused. With the latter, a constant change in the localization of the organ develops with its further return to the bed, while this is not typical for prolapse.

Healthy kidneys are located in the lumbar region

The kidneys are located in the retroperitoneal space and have several fixation mechanisms that provide them with support. These include:

capsule - a dense connective tissue membrane covering the outside of the organ;
ligaments - elastic and elastic fibrous cords, thanks to which the kidneys are attached to various organs and tissues;
fatty tissue - absorbs shocks and falls;
leaves of fascia - a case that secures organs to the diaphragm;
vascular pedicle, consisting of arteries, veins, lymphatic ducts and nerve trunks;
intra-abdominal pressure;
muscles of the lumbar region.

If one or more of these factors is affected, the kidney begins to slowly shift due to gravity. Most often, the right organ is lowered, since it is initially located slightly lower than the left. The process of development of the disease itself proceeds quite smoothly, due to which it is rarely possible to detect the disease at the initial stage.

The main factors contributing to kidney prolapse:

intense physical activity;
frequent lifting and carrying heavy objects over long distances;
carrying a pregnancy (especially with several fetuses or a large child);
hereditary connective tissue diseases (associated with collagen deficiency and low fiber elasticity);
muscular dystrophy and atrophy;
sudden change in body weight;
development of benign or malignant neoplasms;
prolonged immobility (disability, coma);
curvature of the spine (hunchback, high-grade scoliosis);
eating disorders (vegan and vegetarian diet with low protein);
pelvic organ injuries;
surgical interventions in the kidney area;
inflammatory diseases;
urolithiasis.

Video: Elena Malysheva talks about nephroptosis

What types of disease exist and their clinical manifestations

Depending on the severity of the lesion and the intensity of the severity of symptomatic signs, it is customary to distinguish between three degrees of nephroptosis. Remember that the disease progresses gradually, so intermediate stages are often detected during the initial examination.

When nephroptosis is detected in the initial period, treatment is much faster than if the pathology is detected in the advanced phase. That is why doctors strongly recommend not to delay going to the hospital.

During the process of descent, the kidney goes through three stages

For the first degree of kidney prolapse, a complete absence of clinical symptoms is typical. This finding most often occurs by chance during a routine examination, urography or ultrasound of other systems and tissues. If you ask the patient to take a deep breath, you can feel the organ in the hypochondrium. The appearance of pain syndrome is associated with intense physical activity, bearing a child, exposure to a strong stress factor or nervous strain, which aggravate the course of the disease.

In the second degree, the organ is displaced below the costal arch, which leads to increased severity of clinical symptoms. Patients complain of intense pain localized in the lumbar region, urinary disturbances in the form of retention and discomfort. The lower edge of the kidney can be felt completely (in people with an asthenic constitution it is even easy to see). At the same time, general symptoms begin to appear in the form of intoxication, nausea and vomiting, as well as a rise in temperature.

The third degree of the disease is characterized by migration of the kidney to the pelvic area. This is accompanied by compression of the neurovascular bundles, as well as serious changes in the formation and filtration of fluid. Patients may experience acute urinary retention and a complete absence of urge, or the release of urine is associated with intense pressing and cutting pain. An increase in body temperature, nausea and vomiting also develops; victims perform the usual amount of work much more slowly. They are accompanied by constant fatigue, lethargy and depression. Also, the third degree of organ prolapse is characterized by an increase in blood pressure by more than 10–15 millimeters of mercury from normal. It is almost impossible to palpate the kidney in the pelvic area.

Table: comparative characteristics of the development of the disease in different sex groups

Clinical symptom	Women	Men
Increased body temperature	Up to 37–38 degrees	Up to 39 degrees
Nausea and vomiting	May cause concern during the initial manifestations of the disease	Practically do not occur or join at later stages
Marked weakness and decreased resistance to physical activity	Occurs from the first days of formation of kidney prolapse	Manifest several months after other symptoms
Changes in urine tests	Blood or clots may appear, cloudiness and sediment may appear at the bottom of the jar	Increased number of red and leukocyte cells
Localization and intensity of pain syndrome	In the area of the affected kidney, radiates to the lower thigh and pubis	In the lower back, can migrate under the ribs and into the groin
Presence of renal colic	Don't meet	In 30% of all victims
Palpable formation in the lumbar area	Can be found in patients with low body weight: the contours of a painful kidney usually appear
Characteristics of urination disorders	Cutting, itching and burning of moderate intensity	Retention of urine in the bladder, feeling of incomplete emptying
Difficulties in conceiving offspring	Occur during pregnancy: miscarriages, spontaneous abortions, stillbirths	Don't meet

Clinical symptoms of bilateral renal prolapse

If the disease affects both organs at once, the symptomatic picture is much more pronounced and intense. The disease develops over several weeks (faster than if one kidney is affected). Bilateral pathology is characterized by the manifestation of primary generalized symptoms:

increased fatigue;
reduced performance;
nausea and vomiting in the morning;
swelling of the soft tissues of the face and neck (especially cheekbones, cheeks, forehead and eyelids);
increased body temperature ranging from 37 to 39 degrees Celsius;
increase in blood pressure;
intense headaches and dizziness;
lack of appetite and aversion to food.

Local symptoms of kidney prolapse:

pain in the lumbar region radiating to the groin, thigh or pubis;
changes in urine: increased levels of leukocytes, red blood cells, epithelial and cylindrical cells, increased protein, cloudiness and redness of urine;
the presence of a palpable formation below the costal arch;
pain, burning and itching when urinating;
sensation of a full bladder.

Photo gallery: clinical manifestations of nephroptosis

Lower back pain is typical for kidney prolapse Fever may not always be associated with ARVI Cloudiness of urine is the first sign of kidney problems

Consequences of pathology formation

Unfortunately, many ailments that in one way or another affect the genitourinary system affect human health. When the kidneys prolapse, long-term unpleasant consequences develop, which largely worsen the quality of life. Their formation depends not only on the patient’s behavior, but also on the correctness and timeliness of the diagnosis.

In practice, the author of this article supervised a patient who for a long time could not obtain a conclusion about the state of his health, since his rural hospital did not have special equipment. Despite all the studies, it was not possible to detect stage 1 prolapse of the right kidney, although the patient complained of discomfort in the lumbar region. After two years of diagnostic search using magnetic resonance imaging in the regional medical center, a pathological neoplasm of a malignant nature was discovered, which provoked the prolapse of the organ. The patient was successfully operated on, but his rehabilitation period dragged on for several years due to late diagnosis.

Possible consequences of kidney prolapse:

Tendency to develop infectious and inflammatory diseases of the genitourinary system. Often, pyelonephritis, cystitis and urethritis form in a weakened body with low immunity. When an organ prolapses, it is at a functional disadvantage: it does not receive the optimal amount of oxygen-rich arterial blood and nutrients, which makes it an easy target for various bacteria. It has been scientifically proven that people with this diagnosis are twice as likely to see a doctor with inflammatory problems of the pelvic organs.
Acute or chronic kidney failure. This is an extremely dangerous disease, which is associated with the accumulation in the body of a huge amount of toxins and wastes that clog the blood vessels. Gradually, the human body becomes no longer able to utilize harmful products of its own production, which contributes to the onset of a coma or uremic poisoning.
Problems with bearing a child occur in almost 50% of women suffering from nephroptosis. During pregnancy, the body takes on a double load, since some of the blood flows to the fetus: it is necessary to clean it as much as possible from harmful impurities. The kidneys gradually weaken and cannot provide the flow of fluid with oxygen to the placenta (baby place). This causes the development of such serious complications as intrauterine growth retardation, respiratory distress syndrome, miscarriage, infection and even the death of the child. Many children are born with serious problems of the respiratory and cardiovascular systems.
Organ shrinkage. When the kidney prolapses, its supplying arteries and veins are compressed and deformed, and some tissues are less well supplied with blood. They gradually begin to die and shrink, making it look like a raisin. Unfortunately, the kidney soon mummifies and is perceived by the body as a foreign body (a purulent-septic process may begin), which leads to its complete removal. Such patients are required to attend hemodialysis for life - a complex procedure for artificial blood purification by driving it through special filtration systems.

Photo gallery: consequences of the disease

A wrinkled kidney is reduced in size Coma is a serious condition characterized by depression of consciousness A premature baby is born earlier due to problems with the mother’s kidneys

Lifestyle with kidney prolapse

During nephroptosis, the human body is especially susceptible to the harmful effects of environmental factors. However, few people think about how to behave so as not to aggravate the situation and not provoke the development of unpleasant complications. If you or your loved ones are diagnosed with kidney prolapse, doctors strongly recommend that you abandon your behavior strategies for a while and reconsider your habits, work and eating style. This will greatly help the treatment.

The author of the article examined one patient with a rather severe complication of nephroptosis - renal phlegmon. The organ practically melted from pus, which led to the development of peritonitis - inflammation of the abdominal cavity. The patient was operated on for a little over twelve hours, after which he was placed in the intensive care unit. As it turned out later, the patient not only did not give up his usual lifestyle before the illness (abuse of alcohol, nicotine and drugs, poor diet), but also aggravated his condition by swimming in an open reservoir in the summer, where a huge number of pathogenic bacteria lived. They penetrated the weakened body through the urethra and provoked the development of a purulent-septic complication in the form of phlegmon.

What is strictly forbidden to do with nephroptosis:

Violate the diet prescribed by your doctor. Junk foods like fast food, instant foods, sweets and carbonated drinks bring incredible pleasure to our taste buds, while the rest of the body suffers seriously. All these dishes contain a huge amount of trans fats, fast carbohydrates and various additives and preservatives, forcing us to purchase these products again and again. Such a diet contributes to kidney dysfunction and excess weight gain, as well as the formation of plaques in the walls of blood vessels.
Swim in open waters not intended for public use. Usually such places are not treated in any way, which contributes to the massive proliferation of bacteria in a river or lake. Doctors advise using public beaches that have water safety certificates for swimming.
Abuse alcoholic beverages. They help relax blood vessels and also retain excess fluid in the tissues of the human body. Drinking more than one glass of red wine during the day can trigger the development of addiction.

Methods for detecting pathology

Laboratory and instrumental methods for identifying a diagnosis:

A general urine test allows you to track changes in the physical characteristics and cellular composition of urine. With nephroptosis, cloudiness, the formation of sediment and impurities in the form of flakes and sand particles or small crystals often occur. Red blood cells, lymphocytes, columnar and squamous epithelial cells also predominate, which indicates the presence of an inflammatory process.
Cloudy urine indicates excess protein
With the help of ultrasound diagnostics, it became possible not only to determine the degree of organ displacement, but also to assess the condition of the system of cups and pelvis. With a long course of the disease, they significantly expand and become deformed, and the kidney sinks deeper and further into the pelvic area.
Ultrasound of the kidney allows you to evaluate its structure
Magnetic resonance imaging can identify the cause of nephroptosis. With its help, it is easy to detect a foreign body (tumor, stone or any other object), as well as select the optimal tactics for managing this patient.
The picture shows a change in the position of the left kidney

Various treatment options for kidney prolapse

Drug therapy for the formation of pathology is represented by groups of drugs that help to quickly and efficiently get rid of all of them. These include:

diuretics: Mannitol, Furosemide, Hydrochlorothiazide, Indapamide, Lasix;
antispasmodics: No-shpa, Drotaverine, Baralgin, Spazgan, Pentalgin;
anti-inflammatory drugs: Nimesulide, Askofen, Tamoxifen, Ibuklin, Nise;
antihypertensive medications: Capoten, Captopril, Perindopril, Enap, Labetalol.

Photo gallery: cures for symptoms of illness

Furosemide removes excess fluid Pentalgin relieves spasms
Captopril normalizes blood pressure

Surgical elimination of the problem involves suturing the affected organ using a special biological mesh to the surrounding tissues. The peritoneum and diaphragm can be used as support. The operation is performed under general anesthesia, after which the patient is sent to the intensive care unit for a recovery period, where he gains strength and energy within two days.

Therapeutic gymnastics during the development of the disease allows you to strengthen the abdominal and lower back muscles, as well as avoid relapse:

From a lying position on the mat with your back, bend both legs at the knees, place your feet parallel, and extend your arms along your body. Slowly and smoothly move your pelvis up and down at least twenty times.
From the same position, alternately lift your straight right and left lower limbs, feeling the tension in your abs. The recommended number of executions is ten.
Lying on your stomach, lift your legs and arms off the floor, then pull them as far as possible in different directions, trying to maintain your balance. It is necessary to maintain the pose for at least two minutes.

Video: gymnastics for illness

Prognosis for recovery and possible complications of kidney prolapse

Recovery from nephroptosis is a fairly long period that can take months or even years. The patient needs to mentally prepare for a long period of rehabilitation, as well as comply with all medical instructions. The kidney returns to its place immediately after the operation, and the main symptoms are easily relieved by taking medications, but to consolidate the results obtained, it is necessary to build up the muscle frame. The duration of recovery largely depends on the age of the victim and the presence of chronic diseases. It is known that children and adolescents recover the fastest when their bodies cope well with the stress factor.

In his practical work, the author of this article saw a patient aged 65 years, who, even before the disease, actively visited the pool and therapeutic physical exercises. After she underwent surgery to eliminate left-sided nephroptosis, the woman began to strengthen her lower back muscles, working out right in the ward and exercise therapy room. She also adhered to a therapeutic diet and constantly took prescribed pharmaceutical medications to reduce the severity of her symptoms. All this contributed to the fact that after two months there was no trace left of the disease.

Possible complications of kidney prolapse:

Symptomatic arterial hypertension is a sharp increase in the level of systemic pressure more than the usual norm by 30–40 millimeters of mercury. It manifests itself as pressing pain in the temporal region, which intensifies with physical activity or stress. A particular danger of this disease is the possibility of developing a hypertensive crisis - a sharp jump in pressure by 1.5 times or more.
The addition of a secondary purulent infection and the development of an abscess, carbuncle or phlegmon of the renal tissue. This complication is quite rare, but is characterized by an extremely malignant course: the patient suffers from severe fever and intoxication. Often the disease is accompanied by infectious-septic shock, arrest of cardiovascular and respiratory activity. In especially severe cases, the death of the victim develops.
Compression of the neurovascular bundle that supplies the organ with nutrition. In this case, some part of the kidney tissue dies, which can lead to a decrease in its size and severe dysfunction.

The most important preventive measures

Modern medicine, according to the basic rules of the World Health Organization, is primarily aimed at protecting and maintaining the health of citizens. That is why most diseases of the genitourinary system are much easier to prevent than to treat. All prevention methods are divided into individual (performed directly by the patient himself) and mass (performed by specially trained people with medical education). The latter include conducting various surveys, lectures, seminars and schools for personal health of citizens.

While studying at the Department of Urology, the author of this article, together with his teachers and classmates, participated in organizing a conference that was dedicated to preserving and maintaining the health of the genitourinary system. One of the most important problems discussed at this meeting was kidney prolapse. The doctors organized a special seminar where all interested patients interested in considering nephroptosis could come. The students made educational posters that clearly showed the way of life with such a pathology, as well as special brochures that demonstrated the correct performance of therapeutic exercises. All patients were asked to undergo a test consisting of twenty questions to determine the level of health of the genitourinary system and hidden complaints, as well as to assess the intensity of physical activity. Based on the results of the data obtained, it was revealed that more than half of the citizens studied suffer in one way or another from diseases of the genitourinary system, and 20% of respondents lift and carry heavy objects incorrectly.

Basic rules for preventing kidney prolapse:

Maintain personal hygiene. Few people know that the surface of the external genitalia is home to a huge number of pathogenic bacteria, which, when the immune system is weakened, begin to actively grow and multiply. This often provokes the appearance of pyelonephritis, pyelitis, nephritis or glomerulonephritis - inflammatory diseases that can cause the development of nephroptosis. This is why it is so important to take a shower every day (in the morning or evening as your body gets dirty), using intimate hygiene products. They are sold in pharmacies or supermarkets, and unlike regular soap, they do not kill beneficial microflora and do not provoke the development of dysbacteriosis.
Lift weights correctly. Most of the population deliberately refuses to use special carts and mechanisms that make work easier. This leads to a broken back and severe pain in the lumbar region, and the muscular frame that holds the kidney in its bed also suffers greatly. To avoid getting herbs, it is necessary to lift heavy objects by lowering yourself to the same level as them, and not from a standing position while bending over. This will help to evenly distribute the load on the muscle groups of the shoulder and pelvic girdle, as well as avoid rupture of ligaments and tendons.
When lifted correctly, the load is distributed evenly
Get regular physical activity. The sedentary lifestyle that the vast majority of the population leads contributes to the accumulation of excess fat deposits, the development of hypertension, varicose veins of the lower extremities and diabetes. Also, with prolonged absence of movement, patients experience serious depletion of the muscle frame: the muscles atrophy and are gradually replaced by fatty and connective tissue. In this case, prolapse of many organs occurs, including the kidneys. Doctors strongly recommend spending at least half an hour twice a week doing simple exercises. This helps keep your body in good shape and will also protect you from the development of many infectious diseases. If your life schedule does not allow you to train or visit the gym, you can do fifteen-minute warm-ups during work days or during your lunch break.
Get rid of excess fat mass or gain weight gradually. Most organs of the human body have a layer of fat that helps maintain them at a certain level. When it increases or suddenly decreases, the kidney sag and it loses most of its fixation apparatus. This is why doctors prohibit losing 5 kilograms of body weight in one month or gaining more than 10% in six months. If you have eating disorders, you need to contact a nutritionist so that he can create an optimal meal plan in combination with physical activity.
Weight loss should be gradual so as not to cause kidney displacement
Treat chronic diseases of various organs and systems. It has long been known that the cause of the development of kidney inflammation, urolithiasis or tumors can be a forgotten infection: untreated caries, a scratch, a boil or even a small pimple. To avoid the development of such a disease, you need to carefully monitor your health, visit a doctor every six months, and regularly take sick leave. Remember that during an epidemic of influenza and ARVI, it will be much better to rest at home with a fever than to go to work and get serious complications. It is worth taking blood and urine tests at least once every six months: this will help identify sluggish chronic processes.
Eat right. All dishes you prepare must be boiled, stewed or baked; frying is allowed in a minimum amount of vegetable oil. Salt consumption should be kept to a minimum: no more than 4–5 grams during the day. The number of meals is at least six (breakfast, lunch, dinner and two light snacks), and the recommended calorie content is up to 4000. The diet should be dominated by fresh vegetables, berries and fruits - they are a complete source of essential vitamins and microelements. It is also worth focusing on liquid and soft nutrition: soups, cereals and purees will become the basis of your diet. For meat you can use chicken, turkey, pork and beef with a minimum amount of fat. Eating seafood (shrimp, mussels, lobster) and fish will be no less beneficial. Milk, plain yoghurts, kefir, fermented baked milk, cottage cheese and sour cream will help replenish calcium reserves in the body. Snacks include peanut butter crisps, nuts, vegetable or cereal cookies, and energy bars.
Proper nutrition speeds up metabolism

Every year, about 1 thousand people become disabled with a diagnosis of advanced nephroptosis. This is largely due to late presentation and insufficient quality of medical care. In itself, kidney prolapse is a rather unpleasant disease with dire consequences. But even if you or your loved ones have been diagnosed with this, do not despair. Competent treatment and compliance with all medical recommendations will help you recover and return to your normal rhythm of life as soon as possible. And also, do not forget about the rules of prevention: only they help reduce the prevalence of the disease among the population.

Kidney prolapse is a pathological condition caused by abnormal mobility of one or both kidneys. Another name for the pathology is nephroptosis. The kidneys can move 10–15 mm when walking and breathing. But a displacement of more than 50 mm is not considered normal. Kidney prolapse to varying degrees is a common pathology.

Mostly, prolapse of the right kidney is diagnosed; more than 70% of cases are right-sided nephroptosis. The left kidney prolapses less frequently, in 10% of patients. The disease is often asymptomatic, not accompanied by pain, and is discovered by chance, during echography or x-ray. Only 15% of patients with nephroptosis complain of severe pain.

The kidneys, as the most important paired organ of the urinary system, are responsible for maintaining the body in a stable state by cleansing the blood of toxins and waste products. Their role in stabilizing the balance of chemicals is no less important. The organ is bean-shaped, the left kidney is dominant in size over the right.

Stable fixation of the kidneys in the peritoneal region is ensured by:

a vascular pedicle, which is based on the renal artery and veins, but the pedicle is capable of stretching and does not provide proper fixation;
a fat capsule consisting entirely of fat cells; its purpose is to protect the organ from injury;
fascia of the kidney - sheets of connective tissue; fascia is responsible for the location of the organ in a suspended state due to fusion in the upper pole of the kidney and transition to the diaphragmatic fascia;
renal bed formed by the diaphragm, the muscular layer of the abdominal walls and the mesentery.

The fixation apparatus is complex; for adequate work to hold the organ in the anatomically correct position, the well-established functioning of all components is necessary. If one of the components weakens, the kidney sinks downward under its own weight.

Types of pathology

Kidney prolapse is divided into 3 stages:

Stage 1, or the initial stage of nephroptosis - the organ is displaced by 20–40 mm, no more; a drooping kidney can be felt just below the edge of the costal arch at the moment of inhalation, or when moving from a lying position to a vertical one;
Stage 2 - the prolapsed kidney moves downwards by 40–60 mm, but when the organ returns to its horizontal position, it returns to its place; the ligamentous apparatus is stretched significantly, at stage 2 the first signs of the disease begin to actively appear in the form of pain and negative dynamics in urine tests;
Stage 3 - the kidneys can move up to 10 cm into the pelvic area; the patient's condition worsens, there is a high risk of developing functional failure and other complications.

Depending on the intensity of pathological kidney mobility, the following are distinguished:

limited nephroptosis - the organ moves downward due to thinning of the fat capsule, but the degree of movement is limited by the elasticity of the ligaments;
wandering kidney syndrome - a pathology in which the organ can move into the pelvic region; The development of the syndrome is provoked by a combination of thinning of fatty tissue and decreased elasticity of the ligaments.

Occasionally, increased activity is observed in the movement of the kidneys not vertically, but rotationally - rotation around the renal legs, or movement from side to side (like the movements of a pendulum). This is a particularly dangerous condition - the renal veins and arteries are twisted and stretched, which leads to a narrowing of their lumen. Torsion and stretching disrupt blood flow and circulation of lymphatic fluid, causing an increase in pressure in the tubules.

Provoking factors

The causes of kidney prolapse are due to external and internal factors. Prolapse develops with a weak ligamentous apparatus and its inability to maintain the optimal location of the kidneys. Factors contributing to weakening of ligaments are diverse:

the gestation period and childbirth provoke severe stretching of the abdominal muscles, which causes loss of support for the kidneys; a large volume of the abdomen during pregnancy, repeated pregnancies increase the risk of developing nephroptosis;
intense prolonged cough, which is a symptom of infectious and viral diseases (whooping cough, tuberculosis, obstructive bronchitis) leads to the impact of the diaphragmatic muscles on the peritoneal organs, displacing them downward;
intense physical activity associated with lifting heavy objects creates increased intra-abdominal pressure and increases the risk of sprained ligaments and fascia;
bruises, falls, and other injuries violate the integrity of the ligamentous apparatus, causing the formation of cracks and tears; injury to the lumbar region causes the appearance of hematomas that put pressure on the kidneys;
weight loss in a short time causes a decrease in the thickness of the fat capsule, as a result of which the kidney loses support and moves downward;
low physical activity leads to a decrease in pressure in the peritoneal cavity and a weakening of the muscle layer, as a result - the kidneys leave the bed, the fascia stretches;
heredity - diseases associated with weakness of muscle and connective tissue (imperfect desmogenesis, dysplasia) in blood relatives on the same line increase the risk of nephroptosis;
negative effects of vibration and shaking over a long period;
damage to the fat capsule and ligamentous apparatus during surgical interventions;
severe diseases that cause dystrophy - cancerous tumors, cirrhosis of the liver;
age - in older people, the abdominal, pelvic, and lumbar muscles weaken and lose elasticity, which causes prolapse of the internal organs;
congenital underdevelopment of the ligamentous apparatus due to genetic defects.

Symptoms

Symptoms of kidney prolapse tend to intensify as the pathology progresses. At stage 1, the patient does not feel discomfort or pain, feeling healthy. But over time, the kidney moves lower, leading to the appearance of negative symptoms.

Pain syndrome is the main clinical sign of nephroptosis. When the kidney prolapses, the pain is concentrated in the lower back; it is dull and aching in nature. The reason for the pain lies in the stretching under the influence of the fibrous capsule, which is swollen from a lack of blood supply to the kidney, containing many nerve receptors. Pain with nephroptosis decreases in the supine position, when the outflow of blood decreases. At stage 2, the pain syndrome becomes paroxysmal; at stage 3, the lower back hurts constantly.
Pain in the abdomen and groin area is associated with irritation of nearby nerve fibers. The nature of the pain is acute, burning, and some people mistake it for manifestations of acute appendicitis. Particularly severe attacks may cause the patient to lose the ability to move and speak.
The appearance of blood impurities in the urine is caused by torsion of the vascular bundle, during which the veins burst and the blood enters unchanged into the urine. Urine takes on a specific “meat slop” color.
A disorder in the functioning of the gastrointestinal tract is caused by a disruption in the passage of nerve impulses due to reflex irritation of receptors in the organs of the digestive tract. Patients experience decreased appetite and periodic nausea and vomiting. The stool is disrupted - constipation and diarrhea may alternate.

As the prolapse progresses, it threatens to intoxicate the body. At stages 2–3 of the disease, the kidneys cannot fully filter the blood and plasma from toxins. The concentration of harmful substances in the blood increases, and uremia develops. The patient is weakened, gets tired quickly, and there may be an increase in body temperature during painful attacks.

Complications

Many people are concerned about the dangers of kidney prolapse. If left untreated, the pathology leads to the development of a number of serious complications, the most serious being renal failure with persistent loss of the main functions of the organ. The consequences of untreated or improperly treated nephroptosis boil down to the development of:

venous hypertension of the renal vessels caused by lengthening and torsion of veins and arteries;
pyelonephritis - acute inflammation provoked by insufficient supply of nutrients to the kidneys and subsequent ischemia; due to a lack of oxygen, the defenses are reduced and the organ becomes defenseless against pathogenic flora coming from the bloodstream or from the urinary tract;
hydronephrosis - a condition associated with stagnation of urine in the kidney tissues; prolonged stagnation leads to atrophic changes in the parinchematous layer;
urolithiasis, developing due to salt deposits in the renal ducts; As the volume of salt deposition increases, stones are formed that can cause a severe attack of renal colic.

The course of pathology in children

Nephroptosis occurs in childhood, but is rarely diagnosed - in 4.7% of cases. Moreover, girls suffer from kidney prolapse 8 times more often than boys. The cause of excessive mobility of the kidneys in a child is caused by an imperfect ligamentous apparatus. Often the kidneys prolapse in children with spinal scoliosis. Pathology leads to persistent disorders in hemo- and urodynamics, increases the risk of developing inflammatory processes, hypertension, urolithiasis and renal failure.

The course of the disease in childhood can take several forms:

asymptomatic prolapse is diagnosed in 13% of the total number of patients, and by chance - during examination for other diseases;
clinically manifest nephroptosis is detected in 43% of patients, the clinical picture includes abdominal pain, urination disorder, signs of arterial hypertension, and delayed physical development;
complicated nephroptosis is characterized by aggravated course, the child suffers from severe pain, nausea and diarrhea; due to renal dysfunction in the urine, the concentration of protein and leukocytes critically increases, and red blood cells appear; Urinary incontinence develops not only at night, but also during the day.

A child with suspected nephroptosis is subject to an urgent comprehensive examination in nephrology departments and specialized centers. Treatment when the disease is confirmed is conservative; operations on children are performed only in advanced cases.

Diagnostics

If a prolapse is suspected, the examination is carried out by a nephrologist. At the initial visit, the doctor clarifies complaints regarding the nature and frequency of pain, disorders in the act of urination. It is necessary to perform a digital palpation of the anterior wall of the peritoneum just below the edge of the costal arches.

Urinalysis is a simple but effective test. In persons with nephroptosis, the main indicators change in an unfavorable direction. Proteinuria with a significant increase in protein, over 0.5 g/l, is typical. Hematuria accompanies the course of the disease in every patient with stage 2 prolapse; the number of red blood cells in urine reaches 10 in the field of view.

Among the instrumental diagnostic methods for identifying nephroptosis, preference is given to:

Kidney urography - examination through a series of x-rays with the introduction of contrast; urography allows you to identify which kidney is prolapsed and what the degree of pathology is; the advantage of the study is the ability to carry out diagnostics in both an upright and lying position of the patient;
echography of the kidneys - using ultrasound, it is possible to determine nephroptosis at stage 3; confirmation of the disease in the initial stages is problematic due to the lying position of the patient during ultrasound.

Therapy

Kidney prolapse can be treated conservatively and surgically. The choice of method depends on the stage of prolapse and the nature of the complications. Conservative treatment is indicated for stages 1–2; its goal is to strengthen the ligamentous apparatus, which allows the prolapsed kidney to be raised naturally. Such treatment includes:

bandage (orthopedic therapy) - systematic wearing of a wide supporting corset;
therapeutic physical culture (physical therapy) - a set of exercises that should be done regularly in the morning; Exercise therapy helps strengthen the abdominal press, so that the sagging kidneys can enter the bed and take a physiological location;
Abdominal massage is an effective measure at the initial stage of prolapse; The massage must be performed by a specialist, necessarily in courses lasting at least 10 sessions;
spa treatment - useful for patients at any stage of the disease, especially using hydrotherapy methods (bathing with mineral water, drinking mineral water as a liquid).

Surgical treatment is rarely organized in the absence of a positive result from conservative methods. Surgery for kidney prolapse can only be performed according to strict indications:

intolerable pain causing loss of ability to work;
the course of the pathology with complications (hydronephrosis, kidney failure) that are difficult to treat with drug therapy;
internal bleeding from the vessels of the kidney;
multiple kidney stones;
arterial hypertension that is difficult to correct.

During surgery, the following methods of fixing the kidneys are used:

suturing the fibrous capsule with a kergut suture, followed by fixation of the kidney to the lower rib or muscle layer of the lower back;
securing the renal capsule with flaps taken from the connective tissue of the inner lining of the peritoneum;
securing the kidney with synthetic hammock-shaped flaps;
securing the organ in the renal bed with muscle flaps taken from the patient’s thigh muscles;
Laparoscopic operations are considered modern non-traumatic methods of getting rid of the disease; suturing of the fibrous layer of the capsule is carried out using flexible tubes with fixed instruments.

Diet and lifestyle

Effective treatment of nephroptosis is impossible without diet. The patient should eat a varied diet, but with the exception of foods rich in extractive substances (sauces, rich meat soups) - this will reduce the irritating effect on the kidneys. Meals are fractional, up to 6 meals per day. The liquid should be consumed wisely - at least 1500 ml.

If kidney failure develops, it is important to reduce protein intake to 25 g per day. Proteins of plant origin in excess are especially harmful due to the risk of overloading the body with toxins. The daily intake of phosphorus is subject to regular monitoring, the excess of which is harmful to bone tissue. Salt intake is also reduced - excess sodium can cause swelling.

The lifestyle of patients with nephroptosis should be calm and measured. Physical activity, running, jumping, and horse riding are prohibited. But adequate physical activity must be present - walking and low-mobility games are useful. It is useful to do special exercises to strengthen the abdominal muscles - “scissors” (crossing legs from a reclining position), “bicycle”, lumbar bends.

Prevention

To prevent nephroptosis, it is important to follow simple rules:

follow the principles of rational nutrition to maintain immunity;
monitor the condition of the abdominal muscles;
Pregnant women are recommended to wear bandages starting from the 7th month of gestation;
persons who are forced to work standing for a long time are recommended to periodically take a horizontal or sitting position, at least for a couple of minutes;
prevent excess weight gain;
Avoid diets that cause sudden weight loss in a short period of time.

If there is a primary degree of pathology, you should regularly undergo preventive examinations, conduct sonography and have your urine analyzed. Such measures make it possible to monitor the condition of the kidneys to prevent progression of the disease.