Hydronephrosis In Infants – 5 Causes, 7 Symptoms & 3 Treatments You Should Be Aware Of

Written by MomJunction • 

Does your infant suffer from hydronephrosis? Is her urine cloudy? Are you worried about her situation? If you can relate to these questions, or you know someone who can, read our post. Here, we look at hydronephrosis and how it affects infants.

What Is Hydronephrosis In Infants?

Hydronephrosis is a common urological problem, where the kidneys enlarge due to excess fluid. It typically occurs due to an obstruction in filtering out urine. The condition mostly occurs while you are pregnant, usually during the first trimester. Sometimes, you may discover it in the later stages of pregnancy (1).

Important Facts About Hydronephrosis In Infants:

To understand your infant’s medical condition, it is necessary to know some facts about hydronephrosis. Here are some key facts that can be of help:

  • Almost 1 in 100 babies contract hydronephrosis.
  • In hydronephrosis, the drainage system of your infant’s urine from the urinary system will get affected. It means that the condition will affect your infant’s kidneys, uterus, urethra, and the bladder.
  • In case the urinary system gets blocked or cannot function the way it is supposed to, it can lead to a backup of urine and cause swelling in the kidneys.
  • The first step to treating the condition is to identify the cause of the condition. Is something blocking the flow of the urine or whether the urine is going back through the urinary system, and causing reflux.
  • Ultrasound helps detect hydronephrosis. In most cases, the condition is treated soon after your baby is born.
  • Infants who have mild or moderate hydronephrosis will not experience any damage to their kidney.

Causes Of Hydronephrosis In Infants:

Here are some of the causes that could lead to hydronephrosis:

  1. When the ureters, which carry urine to the bladder from the kidney, become narrow.
  1. If there is a blockage in the kidney or the bladder.
  1. If there is a vesicoureteral reflux, where, the valve between the ureter and the bladder does not function properly. As a result, the ureter pushes the urine back into the kidney every time the bladder gets empty or full.
  1. In rare cases, the condition can occur due to a duplication anomaly. In such a case, one of the ureters is obstructed.
  1. Another reason could be a multicystic dysplastic, in which the kidney does not function the way it is supposed to.

Symptoms Of Hydronephrosis In Infants:

If your infant suffers from hydronephrosis, you may find the following symptoms:

  1. Your infant may experience pain in the abdomen – sometimes, the only way your infant can express the pain is by crying without obvious reason
  1. Having difficulty or pain while passing urine – again, your infant may cry a lot while passing urine, without any obvious reason
  1. Frequency of urinating
  1. Fever
  1. Cloudy urine – if your infant contracts urinary tract infection (UTI) as a result of hydronephrosis
  1. Your infant may not want to feed
  1. Continued irritability and crying without any obvious reason

Diagnosing Hydronephrosis In Infants:

In most cases, your infant’s condition will go away by itself without causing any harm or requiring any medical intervention. However, here is how your doctor will go ahead with the diagnosis:

1. Ultrasound:

  • A few days after birth, the doctor will perform an ultrasound test to check your infant’s kidneys. In case the condition persists, the doctor may recommend some more tests.
  • Ultrasound checkups and regular monitoring can often help you learn about hydronephrosis. Your infant’s doctor will use ultrasound to check the urinary tract.

2. Voiding Cystourethrogram (VCUG):

  • Depending on your infant’s situation, the doctor may use a voiding cystourethrogram technique.
  • A catheter will be placed in your infant’s bladder to rule out any vesicoureteral reflux.
  • For VCUG, the doctor will take an X-ray image of your infant’s bladder and urethra while the bladder is still full. Your infant may need to be sedated for the procedure though anesthesia is not needed.
  • A special dye, known as the contrast medium, is used to fill your infant’s bladder and urethra. It helps the images come out clearer in the X-ray results.
  • The test will help the doctor understand if there is any reflux or blockage.

Treating Hydronephrosis In Infants:

  1. In case, the above technique confirms that vesicoureteral reflux is the cause of the hydronephrosis, the doctor may recommend some antibiotics. The doctor will closely monitor your infant using regular ultrasounds and voiding cystograms.
  1. In case, your infant’s doctor fears there is a danger to the kidneys due to blockage or obstruction, you may be recommended to go for a surgical procedure called pyeloplasty. It will help remove the blockage and help the kidney function and develop naturally. Surgery will only occur once the doctor assesses the amount of blockage in your infant. Once he completes the surgery, a small tube, known as the tent, is usually placed in the urethra or ureter. It helps keep it open temporarily while the wound heals.
  1. If the reason is neither obstruction nor reflux, regular monitoring and ultrasound is all that is needed to help treat your infant.

Complications Of Hydronephrosis In Infants:

While in most cases the condition will get resolved on its own, it can sometimes cause complications if left untreated.

  • If your infant suffers from regular urine blockage, it can damage the very sensitive and developing kidneys.
  • Once the condition is prolonged, it can also reduce the ability of your infant’s kidneys to carry out their role of filtration.
  • In severe cases, your infant will pass either very little urine or sometimes, none at all. It can put your infant at a higher risk of contracting urinary tract infection (UTI) which can lead to permanent damage to the kidneys.

In most cases, doctors will diagnose hydronephrosis during your pregnancy. If it is present in your infant after birth, do not panic, as it is a treatable condition.

If you have experienced the above condition, do share your tips here to help other moms.

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