Nephroptosis of the kidney: symptoms and treatment. What is the diet for patients with kidney nephroptosis?

All human organs are in close relationship with each other. This provides homeostasis (constancy of the internal environment) of the body, so necessary for the normal functioning of all cells. First of all, systems supporting the most important constants (acidity, temperature, concentration of various ions) include cardiovascular and urinary. Since the first of them provides blood circulation, the main nutrient medium, and the second - the allocation of unnecessary metabolites, fluids and toxins.

The role of the kidney in the body

At first glance, the urinary system seems much less significant than, say, respiratory or cardiovascular. After all, enough people live peacefully and with a single kidney, while the absence of one lung or heart transplant clearly affects the patient's condition. However, this is only a delusion, because from a liver-kidney failure a person dies as quickly as from a respiratory or cardiac failure. And this is due to lightning-fast developing toxinemia, because these two organs are the main "filters" of our body, and daily they pump tens of liters of blood through themselves, neutralizing dangerous substances and releasing them into the environment.

Metabolic functions

In addition , the kidneys maintain a constant blood pressure in normal and with blood loss, and it is in them is the main regulator of this indicator - the renin-angiotensin-aldosterone system (RAAS). Also, due to the selective permeability of capillaries in the parenchyma of this excretory organ, the balance of various electrolytes and osmotic components in the blood and tissues is ensured: sodium, potassium, calcium, magnesium, glucose, proteins, acids and many others. They also participate in erythropoiesis, since it is in them that the special substance erythropoietin, a stimulant for the synthesis of red blood cells in the bone marrow, is produced.

Anatomy of the kidney

These organs are paired and located in the lumbar region along the sides of the spinal column. They have a bean-shaped shape and are turned by concave parts to each other, and these grooves are called "gates", they enter the artery and nerves, the vein, the ureter and the lymph vessels exit. These formations not only carry out the metabolism of the kidney, but also serve as part of the fixing apparatus. Inside, these organs have a complex structure: everything starts with a nephron, a capillary glomerulus through which, in fact, the blood is filtered. There are up to a million of them in the kidney, and then they pass into the tubule, in which there is a further concentration of blood, the reabsorption of water, amino acids, glucose and salts, resulting in the ready-made secondary urine.

Urinary tracts

Further, it goes a long way, going to small, and then large cups and a renal pelvis, and ultimately to the ureters flows into the bladder and, finally, through the urethra, is released outward. Thus, each department of the urinary system has its function, and in any of them specific abnormalities may arise, leading to a malfunction. This, for example, kidney nephroptosis or hydronephrosis, pyelonephritis, glomerulonephritis, urolithiasis, congenital strictures, urethritis, cystitis and others. In this article we will dwell on the first disease in particular, however, before starting to consider it, it is necessary to learn some more features of the structure of this organ.

Kidney fixation

They are in the retroperitoneal space, and therefore have a special fixing apparatus to maintain themselves at the same level (from the 12th thoracic to the 2 nd lumbar vertebrae). This includes the peritoneal folds (the right kidney - due to the duodenum-hepatic and renal-hepatic ligaments, and the left one - due to the diaphragmatic), their special anatomical muscular bed, vessels (were mentioned earlier), the fascial-fat apparatus A set of fascial bundles and three membranes that create a "soft pillow" together and a strong support) and intra-abdominal pressure, which is provided by the tension of the muscles of the abdominal walls. Thus, these organs are fairly tightly fixed in the lumbar region. At the same time, the right kidney is slightly lower than the left one, and they still remain quite mobile: in breathing acts, they can descend and rise by 1-2 cm, but for certain pathological influences this amplitude goes beyond 2 cm, and then they drop Below the normal border, this condition is called nephroptosis of the kidneys.

Etiology and risk factors

Pathological mobility is more common in women, because they are characterized by greater extensibility of the ligamentous apparatus than in men, and can arise from a variety of causes that somehow cause the weakness of the fixing apparatus. Primarily renal nephroptosis can cause:

• A sharp loss of body weight, due to which the fatty capsule of the body is thinned, and it becomes more mobile;
• Trauma to the lumbar region or abdomen, disrupting the integrity of the fascia or destructuring the muscular bed of the kidneys, for example kidney nephroptosis often accompanies retroperitoneal post-traumatic hematomas;
• A sudden increase in severity or professional sports, in which there is a strong muscle tension and an increase in intra-abdominal pressure, but the constant influence of this factor stretches the ligamentous apparatus, under the influence of which the kidney can slide to a lower position;
• The weakness of the muscular apparatus, on the contrary, reduces the pressure, and the fixing function also falls, which is why nephroptosis and pregnancy or a hypodynamic lifestyle so often go side by side;
• In addition to the above-mentioned acquired causes, increased tissue extensibility can also be a consequence of hereditary predisposition, for example, in diseases of connective tissue.

Symptoms of the disease

Clinical manifestations of nephroptosis can be divided into stages. Thus, with the first, the affected kidney falls to 4-6 cm with the patient's vertical position and returns independently when it goes horizontal. At this stage, the patient can be bothered only by the drawing pains from the affected side of the waist when lifting weights, with severe physical exertion. Nephroptosis of the left kidney is less common than the right kidney, as it is physiologically located higher, so the majority of the symptoms appear in right-sided localization. If at this stage the disease is lost, then it progresses, and the affected organ can descend to the level of the navel. This is manifested in the second stage of nephroptosis of the right kidney, its symptoms are as follows: the body itself is no longer controlled, it is necessary to manually move to its bed. The pain at this stage intensifies and spreads almost to the entire abdomen and disappears only when the kidney is adjusted and the horizontal position is taken.

Running process

Much more threatening is the nephroptosis of both kidneys, which can develop already at this stage, as a rule, because of a hereditary predisposition. The extreme degree is the lowering of the organ to the small pelvis, then the pains become regular, even arise at rest and do not weaken in the horizontal position, because with such neglect of the disease the kidney is unable to return to normal position by conservative methods. This threatens the development of severe complications, such as hydronephrosis, arterial hypertension, renal colic due to urolithiasis, and the affected organ is much more easily exposed to an ascending infection, resulting in the appearance of pyelonephritis.

Diagnosis of the disease

If the patient has a lean physique, the doctor can still suspect the kidney from falling on the basis of complaints, a history and palpation of the kidneys collected through the anterior abdominal wall.

However, this becomes practically impossible in patients with obesity or with a developed musculature of the abdomen. Then, based on the symptoms of nephroptosis, the patient is sent to the first stage of the examination - a survey radiography or fluoroscopy, so that the pathological mobility of the affected kidney can be determined. If already at this stage the doctor suspects any disease (urolithiasis, congenital anomalies of development, hydronephrosis, a secondarily wrinkled kidney in the background of atherosclerosis or arterial hypertension), then excretory urography with intravenous contrast agent administration is possible. This method has several advantages, for example, it easily visualizes the patency of the urinary tract and their boundaries, stones or nephroptosis of the kidney. Treatment at this stage begins early, first you need to perform ultrasound examination of the abdominal organs, blood and urine tests, as well as their bacteriological culture to confirm or reject the version of the infectious disease.

Remote complications

So, we have figured out in detail what kidney nephroptosis is and how to diagnose this disease. It should also be mentioned that the complications of this disease are reflected not only in the urinary system. So, in the absence of adequate treatment or, for example, if the patient does not follow a diet for nephroptosis of the kidneys, then disorders in the gastrointestinal tract (constipation / diarrhea, anorexia, nausea), renal colic worries more often, which causes neurasthenia develops And the normal passage of urine is disturbed, it compresses surrounding tissues, nerves and vessels. This exacerbates the risk of arterial hypertension with crises or infection of the kidneys, extreme renal failure, which often causes the death of the patient.

Therapy

How to treat kidney nephroptosis in the first stage? This is a solvable question. To do this, it is extremely important to avoid physical exertion, wear special bandages, especially during pregnancy. Individual therapeutic gymnastics is also prescribed, which is aimed at strengthening the muscles of the waist. The patient is advised to strengthen his diet, gain weight, of course, within reasonable limits. Also important is the therapeutic diet for renal nephroptosis №7 with the restriction of the amount of salt (it can be replaced with cumin or lemon juice), broths, snacks, smoked products, fatty foods, sweets and legumes. If the disease goes to stages 2 and 3 and acquires concomitant complications, the only option remains nephropexy, a surgical method by which the kidney is returned to its bed and fixed. And with the development of renal insufficiency, the patient is placed on hemodialysis for periodic purification of blood from those toxins and metabolites that the normally healthy kidney normally worked so well.