From the Guidelines
Mild left hydronephrosis found on a CT abdomen scan is a significant finding that requires prompt follow-up with a urologist or nephrologist within 1-2 weeks for further evaluation to prevent potential permanent kidney damage. This condition indicates partial blockage of urine flow from the left kidney, causing mild swelling of the kidney's collecting system 1. The specialist will likely order additional tests such as a renal ultrasound, urinalysis, blood tests for kidney function (creatinine, BUN), and possibly a diuretic renal scan to determine the cause and severity 1. Common causes include kidney stones, ureteropelvic junction obstruction, pregnancy, or external compression from tumors or enlarged lymph nodes.
Key Considerations
- While waiting for the appointment, it is essential to stay well-hydrated (2-3 liters of water daily) and monitor for worsening symptoms like flank pain, fever, or changes in urination 1.
- Seek immediate medical attention if these symptoms develop, as they can indicate a more severe underlying condition 1.
- Mild hydronephrosis sometimes resolves on its own, but identifying and addressing the underlying cause is crucial to prevent permanent kidney damage 1.
Management
- Pain management with acetaminophen may be appropriate if discomfort occurs, but avoid NSAIDs until cleared by the doctor as they can affect kidney function 1.
- A diuretic renal scan, such as scintigraphic diuresis renography (DRG), can help differentiate nonobstructive hydronephrosis from hydronephrosis due to true functional obstruction 1.
Imaging Studies
- CT urography (CTU) is an imaging study that can improve visualization of both the upper and lower urinary tracts, and it is often used to evaluate hydronephrosis 1.
- Other imaging studies, such as MR urography (MRU) or ultrasound of the kidneys and bladder with Doppler imaging, may also be used to evaluate hydronephrosis, depending on the clinical context 1.
From the Research
Significance of Mild Left Hydronephrosis
The significance of mild left hydronephrosis seen on a Computed Tomography (CT) scan of the abdomen can be understood by considering the following points:
- Hydronephrosis is a condition where there is a buildup of fluid in the kidney, which can be caused by various factors such as obstruction of the urinary tract, kidney stones, or tumors 2, 3, 4.
- Mild left hydronephrosis may be an indication of an underlying condition that requires medical attention, such as a kidney stone or a tumor 3, 4.
- The presence of hydronephrosis can lead to acute kidney injury and, if left untreated, permanent nephron loss 2.
- CT scans and ultrasound are commonly used to diagnose hydronephrosis, and the test characteristics of these imaging modalities can vary depending on the experience of the clinician performing the test 5.
Possible Causes and Complications
Some possible causes and complications of mild left hydronephrosis include:
- Kidney stones, which can cause obstruction of the urinary tract and lead to hydronephrosis 3.
- Tumors, such as renal pelvic carcinoma, which can cause hydronephrosis and other symptoms 4.
- Trauma, which can cause rupture of the renal pelvis and lead to hydronephrosis 6.
- Obstruction of the urinary tract, which can cause hydronephrosis and lead to acute kidney injury 2, 3.
Diagnosis and Management
The diagnosis and management of mild left hydronephrosis typically involve:
- Imaging studies, such as CT scans and ultrasound, to confirm the presence of hydronephrosis and identify any underlying causes 2, 3, 5.
- Medical treatment, such as pain management and antibiotics, to address any underlying conditions 3.
- Surgical intervention, such as removal of kidney stones or tumors, to relieve obstruction and prevent further complications 3, 4.