From the Guidelines
Right renal pelvocaliectasis is a condition characterized by the dilation or enlargement of the collecting system in the right kidney, often caused by obstructed urine flow, which can lead to severe consequences if left untreated, including kidney damage and impaired function over time 1.
Causes and Symptoms
This condition can result from various factors such as kidney stones, ureteropelvic junction obstruction, pregnancy, tumors, or scarring from previous infections. Symptoms may range from flank pain, urinary tract infections, and blood in urine to being asymptomatic if the dilation is mild.
Diagnosis and Treatment
Diagnosis typically involves imaging studies like ultrasound, CT scan, or MRI. Treatment depends on the underlying cause and severity, with minor cases possibly requiring only monitoring, while more severe cases might need treatment of the underlying condition, such as removal of kidney stones, surgical correction of obstructions, or antibiotics for infections 1.
Clinical Considerations
It's essential to consider the potential for severe or prolonged pelvocaliectasis to lead to kidney damage and impaired function over time, emphasizing the need for timely and appropriate management. The condition specifically affecting the right kidney may indicate a localized issue rather than a systemic problem. Given the potential consequences, early diagnosis and treatment are crucial to prevent long-term morbidity and mortality associated with right renal pelvocaliectasis 1.
From the Research
Definition and Causes
- Right renal pelvocaliectasis refers to a condition where the renal pelvis and calyces of the right kidney are dilated [@\3@].
- This condition can be caused by obstructive uropathy, which is a blockage of the urinary tract that can lead to acute kidney injury [@\1@, @\3@].
- The obstruction can be due to various factors, including benign or malignant processes, extrinsic or intrinsic conditions [@\3@].
Diagnosis and Imaging
- Imaging tools such as renal ultrasound, computed tomography (CT) scan, and CT urography can aid in diagnosing the obstructive process and help delineate the etiology and location of the obstruction [@\1@, @\2@, @\3@].
- CT urography can depict urothelial tumors in the upper renal collecting systems, and radiologic signs such as urothelial thickening and endoluminal filling defects can be indicative of tumors [@\2@].
- Renal ultrasound may show mild prominence of the bilateral renal collecting systems with no evidence of hydronephrosis, as seen in a case of obstructive uropathy without hydronephrosis [@\1@].
Treatment and Management
- Treatment of right renal pelvocaliectasis is geared towards alleviating the obstruction, either by restoring the normal urinary flow within the urinary tract or by diverting the urine [@\3@].
- Ureteral stent placement can lead to dramatic improvement in creatinine levels, as seen in a case of obstructive uropathy without hydronephrosis [@\1@].
- Future directions in the management of obstructive uropathy should focus on maximizing urinary drainage while minimizing the morbidities associated with the current available treatment options [@\3@].