Nephroptosis (wandering kidney, omission of the kidney). Nephroptosis (wandering kidney) Signs of kidney prolapse symptoms

25.03.2016

The kidney, as well as other human organs, are fixed inside the body. In this particular case, the fixation occurs with the help of the renal pedicle and bed, and the shell of the kidney itself is fixed on 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 starting treatment, make sure that your symptoms match. So, the symptoms that cause prolapse of the kidney:

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

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

Types of kidney prolapse

There are various degrees and stages of kidney prolapse. Depending on the degree of kidney mobility, it is necessary to distinguish:

• fixing;
• mobile view of a lowered kidney (this pathology is also called a wandering kidney).

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

• symptoms of the first stage - the lower part of the kidney during inspiration comes out of the hypochondrium, and when exhaling it returns to its original position. Such a movement occurs when a person's body changes sharply from horizontal to vertical. Treatment in this case will be the most effective;
• symptoms of the second stage - the kidney is shifted 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 aching dull pain. In this case, treatment should be started immediately, as the consequences can be very negative;
• symptoms of the third stage - stretching of the renal pedicle and its further twisting. The consequences can manifest themselves in the form of difficult urine excretion and the occurrence of infectious complications.

Symptoms of a drooping kidney

Symptoms of kidney prolapse directly depend on the degree of neglect of the process. In the first degree, a person may be unaware that treatment is needed. The initial stages are not always accompanied by painful processes and changes in the biochemical parameters of the blood. 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 find its cause and prescribe appropriate treatment.

At the beginning of the second degree of prolapse, there are aching constant pains that become quite strong, they deprive a person of his ability to work, lead 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 be started, and over time it will be too late to do anything;
• a mobile kidney can cause causes of abortion - miscarriage;
• disability;
• stroke and 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 in the absence of shaking, heavy physical exertion, jumping. What can be done to ease the burden on the kidneys? Reduce the amount of meat and salt consumed, you can follow a special diet for the kidneys, which should be prescribed by a doctor.

If there are no indications for surgical intervention, then the kidney can be fixed, in which case it is recommended to use a 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 can lead to a worsening of the condition. If the patient has a lack of weight, then it is necessary to adhere to a special diet. An increase in the volume of the fat layer will allow you to quickly cope with the disease.

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

If the descent of the kidney happened below the 4th lumbar vertebra, then surgical intervention is necessary. Also indications for surgery may be severe pain, irreversible disorders of the kidney and increased blood pressure of the renal breed.

Folk methods of treatment

Alternative 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 the lowered kidney to its previous state. So, here are some of the most effective recipes for treating a drooping kidney at home:

• sunflower, pumpkin, flax and any nuts can benefit. Flaxseeds should be washed with drinking clean water, sprinkled with powdered sugar and roasted in a dry frying pan. Take orally three times a day, a teaspoon, chewing well;
• chop the stalks of broom kochia and pour boiling water in a ratio of 1: 3. The resulting mixture should be brewed for about 12 hours, after which it should be carefully filtered. Drink the resulting liquid three times a day for a quarter of a tablespoon;
• now we turn to the adoption of healing baths. Cut 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 let it brew for several hours. The resulting solution should be used in its pure form for taking a bath;
• a mixture of flax seeds, echinacea flowers, rosehip petals, knotweed pour boiling water and leave for about 15 minutes. Take three times a day for one month.

Physical exercises with kidney prolapse

The basis of 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 spread out to the sides with palms down. At the same time, we tear off the arms, head, straight legs and chest from the floor as much as possible. We hold in 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 physical fitness is weak, you can only raise your legs, arms and head. Important: the legs should not be bent at the knees;
• Starting position: lie on your back, arms along the body, palms down. We raise each leg, without bending at the knees, in turn. For each leg, repeat 10 times;
• lie on your back, pull your legs to your stomach, bending at the knees. Repeat at least 10 times. There is a simpler option - an identical exercise, but perform for each leg in turn;
• lying on the left, and then on the right side, raise the straight leg as high as possible, repeat 8-10 times;
• for the exercise you will need a small ball: in the prone position, squeeze the ball between the legs above the knees, holding it in a compressed position for 8-10 seconds. Repeat several times.

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

Prevention of kidney prolapse

Sports will be an excellent prevention of kidney prolapse. Morning daily exercises, the so-called exercises, can strengthen the muscles of the whole body, helping them to better cope with heavy unexpected loads. In addition to such charging, 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 a strong press is a reliable guarantee against infringement of the spinal nerve, prolapse of the kidneys and protrusions of the intervertebral discs. A person should not be afraid of regular sports, because this will protect him from the possible omission of the kidney when lifting weights.

People who have the first stage of nephroptosis are advised 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 the treatment in a timely manner, preventing the subsequent development of the disease.

The wandering kidney is a pathology of the urinary system, which is characterized by excessive movement of the renal organ outside the anatomical bed.

Due to the high mobility of the kidney, it can go down a lot, reaching the pelvic area.

The mobile kidney is more characteristic of women due to the peculiarities of the anatomical structure of the body. Elderly people are also susceptible to this pathology.

Both renal organs are mobile by nature, but their normal deviation from their usual place is no more than 1-2 cm.

If the displacement of the kidney exceeds this indicator, doctors diagnose a pathology such as nephroptosis, a type of which is a wandering kidney.

Wandering kidney in the picture

Since the left kidney is higher than the right one, the mobility of the latter is slightly higher, therefore, it is the right kidney that is more often diagnosed as wandering.

Doctors at the moment cannot name with absolute certainty what causes specifically provoke such a pathology.

Normally, the kidneys are displaced during the act of breathing: by 3-4 cm during inhalation, by 5-6 during exhalation. Also, with various body movements, they are also able to move. This determines the normal outflow of urine. There are situations in which the kidney is not able to stay in its allotted place.

This can happen with the weak work of the elements fixing it, among which there are:

• lower back muscles;
• ligamentous structures of the abdominal cavity;
• adipose tissue and fibrous capsule.

All of the above components form the kidney bed, it is different in appearance for males and females. In the first it is cone-shaped, and in the second it is cylindrical.

The main causes of a wandering kidney:

• sudden weight loss, which depletes fatty tissue near the kidney;
• serious injury;
• hereditary failure in the structure of the muscular corset and connective tissue;
• constant exhausting physical activity with lifting heavy objects;
• a short break between two pregnancies or the bearing of several babies at the same time;
• curved spinal column;
• decreased muscle tone in older people.

If the kidney is in an uncharacteristic place for a long time, then during the formation of adhesions it can be fixed there.

Stages of the disease

Wandering kidney can be classified into several stages. In its development, three stages of the pathological process are distinguished.

The first stage, in which the wandering kidney can be determined by palpation.

The kidney is palpated on inspiration. On exhalation, it moves to the right hypochondrium. Usually seen in thin people!

In the second stage, the kidney can move from the hypochondrium. At the same time, in the prone position, it returns to the same place.

The third stage is characterized by the fact that the kidney goes down. Namely - in the pelvis.

In the first stage of this disease, the displacement of the kidney may not cause any symptoms, except for dull pain in the lumbar region, aggravated by exercise. Already at the second stage of nephroptosis, the kidney is able to rotate around its axis, which leads to the development of various complications.

Kidney prolapse has degrees that are distinguished based on its severity:

1. The first degree is characterized by the fact that the mobile organ can be palpated through the abdominal wall during inhalation (if there is no nephroptosis, then the kidney can only be found in thin people).
2. The second degree of its main feature is the protrusion of the kidney from under the ribs in a standing position, with a horizontal one, it hides again.
3. The third degree is distinguished when the kidney appears from under the ribs, both in the vertical and in the horizontal position of a person, and it is also able to wander in the small pelvis.

In children

Nephroptosis in children is rare. So it was believed, at least for a long time. Now the process is quite common.

The wandering kidney is seen on the right. Rather than on the left in children. More often the disease affects girls. Boys are less susceptible to the disease.

What is the etiology of the disease in children? The most common reasons include:

• - heredity;
• - thinness;
• - respiratory diseases;
• - injuries

All these factors, one way or another, contribute to morbidity. It is known that heredity is a common cause. Since with nephroptosis, the mother will certainly fall ill with a child.

In adults

Nephroptosis can appear at any age. This pathological condition of the kidney is observed mainly in women. Although there are cases of manifestation in men.

According to statistics, in 2% of cases, the disease affects women of childbearing age. More common when pregnant. Or under the influence of infections, injuries.

What else can cause the process. The disease can develop with an anatomical predisposition. Suppose the structure of the female organs, one way or another, contributes to the wandering of the kidney.

It is known that women have a certain structure of the pelvis. Wider pelvis and decreased tone of the abdominal wall.

In adults, the kidneys are in a mobile state. When inhaling and exhaling, they move a certain number of centimeters. This directly contributes to the physiological excretion of urine.

The insidiousness of the disease is that with the duration of the location of the kidney. It can be fixed in a certain place for a long time.

Signs of a mobile kidney

Symptoms of the disease

The main difficulty in detecting nephroptosis is the absence of characteristic and pronounced symptoms. As a rule, the development, course, variations and severity of the symptom complex are individual in each case. The most common symptoms include:

• fatigue, weakness, insomnia, frequent dizziness;
• constipation, diarrhea, a feeling of heaviness in the abdomen, bloating, decreased or complete lack of appetite;
• frequent mood swings, hysteria, hypochondria, neuralgia of the femoral, regional and sciatic nerves;
• the presence of hematuria, increased and rapid heartbeat, sharp jumps in blood pressure;
• the formation of pyelonephritis, cystitis, urethritis, pain sensations similar to renal colic, heaviness in the affected side of the lower back, the presence of protein in urine is possible;
• pain in the kidney area, the main feature is the disappearance or decrease in the supine position.

For information! Increased mobility on the right affects the right side, on the left - the left side.

The very first symptom is pain in the hypochondrium. Also, a person may experience a feeling of heaviness in the area of ​​\u200b\u200bthe diseased kidney. In the supine position, these symptoms weaken or even completely disappear. On palpation of the abdomen under the free edge of the ribs with nephroptosis, a kidney is palpated. Pressing on it is quite painful.

Other symptoms of a wandering kidney:

• irritability, irascibility;
• neuralgic pains.

Nephroptosis is a urological disease that affects the urinary system, as a result of which there is an active mobility of the organ and its gradual omission. Wandering kidney (nephroptosis) is the first sign of urolithiasis, arterial hypertension, pyelonephritis, hepatic colic and other urological diseases. In this article we will tell you why a floating kidney is dangerous, we will analyze the symptoms of the pathology and methods of treatment.

Characteristics of nephroptosis

Pathology "walking kidney" is rather complicated and has various complications.

There are permissible norms for the mobility of the organ, they allow the displacement of the kidney by 1-2 vertebrae in the process of respiratory movement and a change in posture. If this rate exceeds the allowable value, nephroptosis or kidney mobility is established. Pathology can proceed in two ways:

• fixed nephroptosis - a characteristic feature is the omission of the organ and its strong fixation;
• wandering kidney - a characteristic feature of the vertical displacement and constant movement of the organ from side to side.

For information! Pathology "walking kidney" is rather complicated and has various complications.

According to statistics, women suffer more often than men from this disease, this is due to the peculiarity of the anatomical structure. As a rule, the disease manifests itself already in adulthood. The displacement of the right kidney occurs more often than the left, this is due to the physiological feature and the undeveloped fixing apparatus of the organ.

For information! Only 10% of nephroptosis is bilateral.

It is worth noting that the fixation of the kidneys in a certain place occurs under the condition of such factors as:

• the presence of renal fascia;
• support of the renal bed, consisting of a square-lumbar and psoas muscles;
• the vascular system of the kidneys, providing interaction with the aorta and inferior vena cava.

You can learn more about the wandering kidney from the video and article what is kidney nephroptosis.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Introduction

The ligaments, fasciae that form the renal bed, intra-abdominal pressure (created by the muscles of the anterior abdominal wall and the diaphragm), the fascial-fatty capsule of the kidney and fatty tissue between the adrenal gland and the kidney keep the kidney at the physiological level.

According to statistics, nephroptosis is currently observed in 1.5% of women and 0.1% of men. The predominant age for this pathology is 25-40 years. Nephroptosis is observed mainly on the right. This is due to the fact that the left kidney has a stronger ligamentous apparatus and the fact that the right kidney is normally located lower than the left one. In some cases, bilateral omission is noted ( ptosis) kidneys.

Causes of kidney prolapse

• significant and rapid weight loss can lead to a decrease in the volume of the fatty capsule of the kidneys;
• hereditary predisposition to increased extensibility of connective tissue (Ehlers-Danlos syndrome);
• trauma to the lumbar region with damage to the ligamentous apparatus and the formation of a hematoma in the perirenal tissue;
• heavy physical activity and labor with heavy lifting;
• infectious diseases of the kidneys;
• excessive stretching of the muscles of the anterior abdominal wall during pregnancy.

Stages of nephroptosis

• at stage 1 the lowered kidney is palpated on inspiration through the abdominal wall, and on exhalation the kidney again goes under the costal margin and is not palpable;
• at stage 2 nephroptosis, the kidney is completely palpable below the hypochondrium with the patient in an upright position, but in the supine position it again goes into the hypochondrium;
• at stage 3 the kidney completely (regardless of the position of the body) comes out of the hypochondrium and can even move into the small pelvis.

Such changes in blood vessels lead to impaired blood supply to the kidney tissue: hypoxia and increased venous pressure, impaired lymphatic drainage. Changes in hemo- and lymphodynamics create conditions for the development of chronic pyelonephritis (inflammation of the pelvis and kidney tissue).

At the 3rd stage of nephroptosis, a kink of the ureter is possible, which will lead to a violation of the outflow of urine and expansion of the renal pelvis. Inflammatory, and then adhesive process may occur around the kidney (perinephritis). These adhesions will fix the kidney in a pathological position. As nephroptosis develops with impaired hemodynamics and urine outflow, clinical manifestations of nephroptosis appear.

Symptoms of kidney prolapse

As the prolapse of the kidney increases, the intensity and frequency of pain increase; diffuse pains in the abdomen with irradiation to the back may appear. At stage II of nephroptosis, protein and red blood cells appear in the urine due to impaired hemodynamics in the kidney.

At stage III, the pain is constantly disturbing and does not disappear in a horizontal position. This may reduce the patient's ability to work. Attacks of renal colic are also possible, when the pain becomes unbearable and may be accompanied by nausea and vomiting.

At stage III of nephroptosis, there is a deterioration in appetite, impaired bowel function, and signs of depression appear. The progression of the disease leads to the appearance of signs of pyelonephritis, an increase in blood pressure, hydronephrosis may form (persistent, progressive expansion of the pyelocaliceal system of the kidney due to a violation of the outflow of urine).

An increase in blood pressure is initially noted only in the upright position of the patient (orthostatic hypertension). In some patients, fornic bleeding (bleeding that occurs during exercise) or symptoms of pyelonephritis are the first manifestations of nephroptosis.

Why is nephroptosis dangerous?

• Violation of the outflow of urine contributes to the development of the infectious process and the formation of calculi (stones) in the renal pelvis.
• A wandering kidney can cause spontaneous abortion.
• With the progression of the process, nephroptosis will cause an increase in blood pressure, which also has very serious complications (strokes and myocardial infarction).

Diagnosis of nephroptosis

• questioning the patient about complaints, past illnesses and injuries;
• examination of the patient with palpation (palpation) of the abdomen;
• x-ray examination (excretory urography and plain radiograph of the kidneys);
• Ultrasound of the kidneys (in the supine and standing position);
• scintigraphy or radioisotope scanning clarifies the position of the kidneys;
• renography allows you to clarify the state of kidney function;
• laboratory analysis of blood and urine allows you to identify and clarify the presence of complications of nephroptosis.

Nephroptosis during pregnancy

Pain in the abdomen increases with physical activity, decreases in the supine position. In this case, nausea, loosening of the stool can be noted. Urinary syndrome is manifested by the appearance in the urine of red blood cells, white blood cells, protein and bacteria. Dysuric syndrome is manifested by urinary incontinence (at night and during the day).

Prevention of nephroptosis in childhood consists in the correct physical education of the child, the exclusion of unbearable loads (including psycho-emotional ones), the provision of rational nutrition and the prevention of childhood injuries.

Treatment of nephroptosis (prolapse of the kidney)

Conservative treatment

Drug therapy is used only for the treatment of complications of nephroptosis (pyelonephritis, urolithiasis, arterial hypertension).

Sodium causes fluid retention in the body, which contributes to edema and high blood pressure. Therefore, the use of table salt should also be limited.

Orthopedic treatment (bandage)
Wearing a bandage is very useful for nephroptosis. Put on a bandage (or orthopedic belt, or corset) should be in the morning, while still lying in bed. Orthopedic bandage should be worn only on exhalation, otherwise wearing it will be useless. Remove the bandage in the evening before going to bed.

Currently, there is a large selection of corsets, bandages, orthopedic belts. Before purchasing any of them, you need to consult a doctor, as there are a number of contraindications for their use. One of the contraindications is "fixed nephroptosis".

exercise therapy
Physiotherapy exercises and abdominal massage have an effect only in stage 1 of nephroptosis. Perform therapeutic exercises daily in the morning for 30 minutes. Exercises are performed in the supine position. A small cushion can be placed under the lower back.

1. The legs are slightly bent at the knees. Make 5-10 breathing movements with the participation of the diaphragm: when inhaling, stick out the stomach as much as possible, and when exhaling, pull it in as much as possible.
2. For 5-8 p. lift up alternately straight legs.
3. For 6-8 p. pull each leg bent at the knee to the stomach.
4. Exercise "bicycle" to perform for 1-2 minutes.
5. Squeeze a small ball between your knees for 6-8 seconds. Exercise repeat 4-5 p.
6. For 5-10 rubles. lift both legs up while inhaling, lowering while exhaling.
7. Raise straight legs up, knees and heels together. As you inhale, spread your legs to the sides, and as you exhale, cross your legs. Repeat exercise 5-6 p.

When the kidneys are lowered, sedentary games and walks on flat terrain are allowed. Jumping, hanging, stretching and running are prohibited.

Spa treatment
At stage I of nephroptosis, spa treatment is widely used, especially with the use of hydrotherapy - bathing, bathing, drinking mineral water.

This treatment can be carried out in local sanatoriums, as well as in the resorts of the Caucasian Mineral Waters (Kislovodsk, Pyatigorsk, Essentuki, Zheleznovodsk) and in Truskavets (Ukraine).

Surgical treatment

The goal of surgery is to fix the kidney (nephropexy) in its anatomical bed for a long time.

Currently, this operation is performed mainly by laparoscopy. It has a number of advantages: less risk of complications, the method is less traumatic, there is practically no blood loss, and the patient's recovery after surgery is easier.

Treatment with folk remedies

Recipes for the preparation of folk remedies:
1. It is recommended to use sunflower seeds, pumpkin, flax, any nuts. Flax seeds can be irrigated with drinking water, sprinkled with powdered sugar and fried in a dry frying pan. Take 3-4 r. 1 tsp per day (carefully chewing).
2. Take 2 tbsp. chopped stems of broom kochia, pour 300 ml of boiling water, leave for 12 hours, strain. Take 5 ml between meals 3 p. in a day.

Nephroptosis (omission of the kidney): causes, symptoms, methods of diagnosis and treatment - video

Treatment of nephroptosis (bandage, laparoscopy) - video

Do they take to the army with nephroptosis?

Nephroptosis in the Schedule of Diseases is classified according to Article 72. The category of suitability is determined depending on the degree of nephroptosis.

Conscripts with nephroptosis of the 1st degree are classified according to Article 72, paragraph "G" - fit for military service.

Examined with nephroptosis II st. and those with secondary pyelonephritis are classified under Article 72, point "B" and are exempted from military service, they are enrolled in the reserve.

Examination for kidney disease is carried out on the basis of inpatient examination and treatment.

Kidney prolapse is acquired increased mobility of one or both organs. Normally, the kidneys can move slightly when changing the position of the body and during respiratory movements, but do not leave the limits of their anatomical bed, formed by ligaments and fatty tissue. When lowered, the organ can move down from the lumbar region, sometimes reaching the pelvic cavity. The omission of the right kidney develops much more often, which is due to its lower anatomical location.

Factors causing the occurrence of pathology

The reasons for the omission of the kidney can be a variety of external and internal factors that lead to a weakening of its ligamentous apparatus. Most often they are:

• significant and rapid loss of body weight, in which the kidney capsule formed by fatty tissue decreases;
• damage to the tissues of the lumbar region caused by direct or indirect trauma (bruises, falls from a height, surgical interventions);
• weakening of the muscles of the lower back and abdomen, caused by advanced age;
• kidney prolapse is often noted during pregnancy (especially with often repeated and multiple births);
• inadequate load (hard work, power sports);
• genetically determined underdevelopment of connective tissue, leading to weakness of all ligamentous apparatuses of the body.

In addition, there are predisposing factors - a long stay in an upright position, constant vibration. This explains why the kidney falls more often in people of certain professions - sellers, dentists, drivers, etc.

Symptoms

With the omission of the kidney, the symptoms depend on the stage of the disease and the severity of pathological changes in the organ.
The disease in the initial, I degree, is manifested by minor pain. With the omission of the right kidney, the symptoms will be localized in the right half of the lumbar region, with left-sided nephroptosis (omission of the kidneys) - on the left. Pain occurs in an upright position, sometimes spread to the abdominal wall and disappear in the supine position.

When the kidney is lowered below the hypochondrium line (II degree of the disease), the pain is more pronounced and may become permanent. At this stage, there is an inflection of the renal vessels and the ureter, which leads to both a violation of the blood supply to the organ and the outflow of urine. Changes occur in the urine (protein and red blood cells appear).

At the III degree of the disease, the symptoms of a lowered kidney are constant pain, which no longer disappears in a horizontal position, attacks of renal colic may occur. In this case, there is a serious circulatory disorder in the kidney and a violation of the outflow of urine due to a strong inflection or twisting of the vascular bundle and ureter. The ischemia of the organ increases, the kidney begins to secrete an increased amount of the hormone renin, which increases blood pressure.

With any omission of the kidney, the consequence in an advanced stage may be the development of severe arterial hypertension with very high pressure figures.

A pronounced delay in the outflow of urine leads to the attachment of an infection - the development of pyelonephritis and cystitis, in which urination occurs often and painfully, chills, and a constant increase in temperature are possible.

Constant pressure on the kidney tissue from retained urine can lead to salt precipitation, stone formation, and the development of hydronephrosis. The latter can lead to almost complete death of the active parenchyma of the kidney and the cessation of its functioning.

Omission of the kidney - what does it threaten for the patient? In the absence of adequate treatment, such a pathology is fraught with the development of renal failure. This life-threatening condition requires constant blood purification through hemodialysis or a donor organ transplant.

Diagnostics

The study of the patient's complaints, the data of his examination, palpation of the lowered right or left kidney in a vertical and horizontal position is usually sufficient to make a diagnosis.
Additionally, ultrasound, excretory urography, CT and MRI of the kidneys can be prescribed.

Treatment

Treatment for kidney prolapse depends on the stage, existing complications, comorbidities, age, and in each case is selected individually. The main directions are conservative and operational methods.

Conservative treatment

This type of therapy cannot completely cure the disease, but it can prevent the development of complications and serves to prepare for surgery in severe forms of the disease.

With minor symptoms of kidney prolapse, treatment may be limited:

• diet;
• gymnastics;
• wearing an orthosis (bandage).

Bandage

A bandage for kidney prolapse will be effective only at stage I of the development of the disease, when there are no gross changes in the blood circulation of the organ and complications.

The device is made of dense and rigid material and is put on in the morning in a prone position, before taking a vertical position. The bandage is wrapped around the waist and fastened after a deep exhalation. The action of the device is based on an increase in intra-abdominal pressure, which causes the kidney to return to its normal anatomical location.

The bandage is contraindicated in severe pain syndrome and the presence of abdominal adhesions. It should be remembered that he can both raise the lowered kidney and fix it in the desired position only for a while. But this method does not replace surgical methods of therapy in the development of complications. In addition, prolonged wearing of the device leads to atrophy and weakening of the lumbar and abdominal muscles, further worsening the problem of fixation of the kidney. Therefore, the selection and use of the bandage must be carried out under the supervision of a physician.

Diet

A special diet is indicated if the prolapse of the kidneys was the result of a rapid and massive loss of fatty tissue. This condition can be observed during starvation (forced or voluntary, for example, with anorexia in girls) or severe debilitating diseases.

A high-calorie diet rich in carbohydrates and fats is prescribed, the purpose of which is to restore the integrity of the fatty capsule of the kidney and the turgor of adjacent tissues. The degree of the disease and the presence of complications should be taken into account. If there is already renal failure and the ability to excrete decay products is reduced, the diet should contain easy-to-digest components that form a minimum of toxins.

Physiotherapy

Gymnastic exercises for kidney prolapse are prescribed in the initial stage of the disease. Their goal is to strengthen the natural muscular corset of the body - the muscles of the lower back and abdominals. These muscles maintain intra-abdominal pressure at a normal level, thereby fixing the kidney in its normal position.

Before starting a set of exercises, it is necessary to evaluate the excretory function of the kidneys. Physical activity should be limited or canceled in the presence of renal failure, other concomitant severe diseases and the presence of severe pain.

Gymnastics when lowering the kidney is a set of simple exercises that the patient is able to perform independently at home. They are usually performed once or twice a day with a total duration of the complex up to half an hour.

An approximate set of exercises for nephroptosis (all exercises are performed in a supine position):

• arms from a position along the body are retracted to the sides on inspiration and return back on exhalation (up to 6 repetitions);
• arms raised above the head, straightened legs alternately rise (up to 5 lifts);
• "walking" in a supine position (up to 2 minutes);
• the knees pulled up to the chest are held by the hands for a few seconds (up to 6 repetitions);
• hands under the head, with bent legs, the pelvis rises on inhalation and lowers on exhalation (up to 5 repetitions);
• arms under the head, simultaneous bending of the legs in all three joints (up to 5 repetitions);
• circular movements with a maximum amplitude of raised straightened legs (up to 5 times);
• slow transition to a sitting position and back (up to 5 times);
• pendulum movements of the elevated pelvis (up to 5 times).

Treatment of kidney prolapse with folk remedies, which include yoga gymnastics, Pilates and other exercises, usually only complements the main methods of treatment, is not independent and requires mandatory medical supervision.

Surgical intervention

What to do if the kidney is lowered and this condition is not amenable to conservative treatment? In such cases, surgery is indicated, which is performed if the disease has reached stage II or III and the following phenomena are present:

• severe symptomatic arterial hypertension;
• omission of the kidney to the IV lumbar vertebra and below;
• persistent pain syndrome;
• the disease is bilateral and complicated by pyelonephritis;
• the threat of developing hydronephrosis due to a persistent violation of the outflow of urine;
• kidney function is impaired, renal failure develops.

The operation allows you to return the kidney to its anatomical bed and exclude its re-displacement by suturing to neighboring tissues. To do this, a muscle flap is cut out, which will later play the role of a “pocket” for the kidney, or a special implant from a special surgical mesh is used. The operation can be performed by the usual method through an incision in the lumbar region or by more modern low-traumatic approaches (laparoscopic surgery).

When choosing how to treat prolapsed kidney and what volume of surgery and type of access to prefer, the surgeon is guided by an assessment of the patient's condition. Minimally invasive methods are usually used in the absence of severe complications and severe adhesions in the abdominal cavity, for a better cosmetic effect (especially in young patients).

In the presence of kidney stones or hydronephrosis, the operation may be supplemented by the removal of stones from the renal pelvis and the restoration of a normal outflow of urine.

Contraindications for surgical treatment:

• extreme severity of the patient's condition,
• the presence of serious concomitant diseases (oncopathology, severe heart failure, severe mental disorders);
• deep senile age of the patient;
• the presence of total splanchnoptosis (general omission of all internal organs).

To know what to do when the kidney is lowered, it is necessary to navigate the symptoms of nephroptosis. The occurrence of pain in the lower back on one or both sides, disappearing in a horizontal position, is a sign of the initial stage of the pathology. If you or someone close to you has these symptoms, see your doctor. The specialist will help prevent the transition of the disease into an advanced phase and avoid serious complications.