Watch Dr. Nitin Explain Kidney Obstruction
Understanding what's causing your kidney swelling and how to fix it
Kidney Obstruction & Hydronephrosis
Kidney & Urinary Tract Health
KIDNEY HEALTH · OBSTRUCTION CARE
A swollen kidney is a warning sign - not a diagnosis. Dr. Nitin Shrivastava identifies the exact cause and treats it, protecting your kidney function for the long term.
The Society for Fetal Urology (SFU) grading system is widely used; urgency of treatment rises with grade
| Grade | Ultrasound Findings | Renal Function | Urgency |
|---|---|---|---|
| Grade I | Mild pelvis dilatation only | Normal | Monitor - 3-monthly USS |
| Grade II | Pelvis + a few calyces dilated | Normal | Monitor + MAG3 renogram if persists |
| Grade III | All calyces dilated; cortex preserved | Mildly reduced | Investigate cause - pyeloplasty likely |
| Grade IV | Severe dilation; cortex thinned | Significantly reduced | Urgent intervention - stent or surgery |
Most common acute cause. Stone lodged at UPJ or UVJ blocks drainage. Usually resolves after stone treatment (RIRS/PCNL/ESWL).
Narrowing or aberrant vessel at the ureteropelvic junction - congenital or acquired. Definitive fix: robotic pyeloplasty.
Post-stone, post-radiation, or idiopathic scarring of the ureter. Treatment: endoscopic incision or ureteric reconstruction.
Retroperitoneal or pelvic tumour (e.g., cervical cancer, lymphoma) extrinsically compressing the ureter. JJ stent as bridge to definitive treatment.
Severe BPH can cause bilateral hydronephrosis and renal impairment. Often the presenting finding of advanced BPH.
Physiological right-sided hydronephrosis is common in pregnancy. If severe or painful, JJ stenting is safe and effective during pregnancy.
| Treatment | When Used | Duration / Recovery | Success Rate |
|---|---|---|---|
| Robotic Pyeloplasty | UPJ obstruction (primary cause) | 2–3 hr surgery; 2-day stay; 2-wk recovery | ~95% long-term success |
| JJ Ureteric Stenting | Acute obstruction, pregnancy, bridge to surgery | 20-min procedure; changed every 3–6 months | Temporary relief; not curative |
| Percutaneous Nephrostomy (PCN) | Emergency drainage; infected obstructed kidney | Immediate drainage under USS guidance | 100% drainage; definitive treatment follows |
| Ureteroscopy + Laser | Stone-related obstruction | 1-hr procedure; 1-day stay | >90% stone clearance; resolves obstruction |
| Endopyelotomy | Secondary UPJ obstruction, shorter strictures | Endoscopic; 1-day stay | ~75% - lower than pyeloplasty |
| Nephrectomy (last resort) | Non-functioning kidney (<10% function) | Laparoscopic; 2-day stay | Removes problem; other kidney compensates |
Understanding what's causing your kidney swelling and how to fix it
Kidney Obstruction & Hydronephrosis
Kidney & Urinary Tract Health
Don't ignore it - kidney function can decline silently. Dr. Nitin will find the cause and recommend the right treatment to protect your kidney.
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MCh AIIMS Delhi · FRCS Oxford · Apollo Hospital Gurugram · 5★ · 450+ reviews
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