II. Epidemiology
- Accounts for 1-10% of Acute Renal Failure cases
- More common in elderly
III. Pathophysiology
- Urinary Tract Obstruction
- Results in renal Pelvis dilatation
- Progressive decrease in Renal Function
- Increased intratubular pressure
- Decreased capillary filtration pressure
IV. Causes
V. Symptoms
- Abdomen or Groin Pain (colic-type attacks)
VI. Signs
- Mass at flank, suprapubic, or central Abdomen
- Abdominal exam
- Pelvic exam
- Rectal Exam
- Anuria (Indicates obstruction in 90% cases)
VII. Labs
- See Renal Function
- Urine Sediment
- Normal sediment
- Hematuria
- Pyuria
- Crystals
VIII. Diagnostic Testing
- Post-void residual >100 ml
- Indicates Bladder outlet obstruction
-
Ultrasound or Intravenous Pyelogram
- Dilated ureters or renal Pelvis
- Abdominal CT or Abdominal MRI
- Percutaneous Nephrostomy drainage trial
IX. Management
- See Acute Kidney Injury Management
- Exclude reversible causes rapidly
- Renal Function recovery reflects obstruction duration
X. Prognosis
XI. Prevention
XII. Resources
XIII. References
- Anderson (8/15/1993) Hospital Practice, p. 61-75
- Meyer (2007) N Engl J Med 357(13): 1316-25 [PubMed]
- Rahman (2012) Am Fam Physician 86(7): 631-9 [PubMed]
- Singri (2003) JAMA 289(6):747-51 [PubMed]
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Related Studies
| Definition (CHV) | water retention in the kidney |
| Definition (CHV) | water retention in the kidney |
| Definition (NCI) | Collection of urine in the renal pelvis that results in dilatation of the renal pelvis and calyces. It is caused by obstruction of urine flow, nephrolithiasis, or vesicoureteral reflux. Signs and symptoms include flank pain, nausea, vomiting, fever, and dysuria. |
| Definition (NCI_NCI-GLOSS) | Abnormal enlargement of a kidney, which may be caused by blockage of the ureter (such as by a kidney stone) or chronic kidney disease that prevents urine from draining into the bladder. |
| Definition (CSP) | distention of the pelvis and calices of the kidney with urine, as a result of obstruction of the ureter, with accompanying atrophy of the parenchyma of the organ. |
| Definition (MSH) | Abnormal enlargement or swelling of a KIDNEY due to dilation of the KIDNEY CALICES and the KIDNEY PELVIS. It is often associated with obstruction of the URETER or chronic kidney diseases that prevents normal drainage of urine into the URINARY BLADDER. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D006869 |
| ICD9 | 591 |
| ICD10 | N13.30 |
| SnomedCT | 197791000, 155866001, 43064006 |
| English | Hydronephroses, Hydronephrosis, HYDRONEPHROSIS, Hydronephrosis NOS, hydronephrosis, hydronephrosis (diagnosis), Unspecified hydronephrosis, Hydronephrosis [Disease/Finding], hydronephroses, Hydronephrosis NOS (disorder), Hydronephrosis (disorder) |
| French | HYDRONEPHROSE, Hydronéphrose, Syndrome de la jonction pyélo-urétérale |
| Portuguese | HIDRONEFROSE, Hidronefrose |
| Spanish | HIDRONEFROSIS, hidronefrosis, SAI (trastorno), hidronefrosis, SAI, hidronefrosis (trastorno), hidronefrosis, Hidronefrosis |
| German | HYDRONEPHROSE, Harnstauungsniere, Hydronephrose, Wassersackniere |
| Japanese | 水腎症, ｽｲｼﾞﾝｼｮｳ |
| Swedish | Hydronefros |
| Czech | hydronefróza, Hydronefróza |
| Finnish | Hydronefroosi |
| Russian | GIDRONEFROZ, ГИДРОНЕФРОЗ |
| Croatian | HIDRONEFROZA |
| Polish | Wodonercze |
| Hungarian | hydronephrosis |
| Norwegian | Hydronefrose |
| Dutch | hydronefrose, Hydronefrose, Nefrose, hydro- |
| Italian | Idronefrosi |
Ontology: Urinary tract obstruction (C0178879)
| Definition (NCI_CTCAE) | A disorder characterized by blockage of the normal flow of contents of the urinary tract. |
| Definition (NCI) | Blockage of the normal flow of contents of the urinary tract. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 599.60, 599.6 |
| ICD10 | N13.9 |
| SnomedCT | 266567006, 266636004, 197936002, 7163005 |
| English | Urinary obstruction unspecif., Urinary obstruction unspecified, obstructive uropathy (diagnosis), obstructive uropathy, urinary obstruction (diagnosis), urinary tract obstruction (diagnosis), urinary obstruction, urinary tract obstruction, Urinary tract obstruction NOS, Uropathy obstructive, Urinary Tract Obstruction, Urinary obstruction NOS, obstructive uropathies, obstruction urinary tract, obstruction tract urinary, obstruction urinary, obstructions tract urinary, Urinary obstruction, Urinary obstruction unspecif, Urinary obstruction unspecified (disorder), Obstructive uropathy, unspecified, Obstructive uropathy, Urinary tract obstruction, Urinary tract obstruction (disorder), obstruction; urinary, obstructive; uropathy, urinary; obstruction, uropathy; obstructive, Obstructive uropathy, NOS, Urinary tract obstruction, NOS, Obstructive Uropathy, Urinary obstruction, unspecified, Obstructive uropathy NOS, Urinary (tract) obstruction NOS |
| Italian | Ostruzione delle vie urinarie, Uropatia ostruttiva, Ostruzione urinaria, non specificata, Ostruzione delle vie urinarie NAS |
| Dutch | uropathie obstructief, urinewegobstructie NAO, urine-obstructie niet-gespecificeerd, obstructie; urine, obstructief; uropathie, urine; obstructie, uropathie; obstructief, obstructieve uropathie, urinewegobstructie |
| French | Obstruction urinaire non précisée, Obstruction des voies urinaires SAI, Obstruction des voies urinaires, Uropathie obstructive |
| German | Harnwegsobstruktion NNB, Harnwegsobstruktion unspezifisch, Uropathie obstruktiv, Harnwegsobstruktion, obstruktive Uropathie |
| Portuguese | Obstrução das vias urinárias NE, Obstrução urinária NE, Uropatia obstrutiva, Obstrução das vias urinárias |
| Spanish | Obstrucción urinaria no especificada, Obstrucción del tracto urinario NEOM, obstrucción urinaria no especificada, obstrucción urinaria no especificada (trastorno), obstrucción de las vías urinarias, obstrucción urinaria, uropatía obstructiva (trastorno), uropatía obstructiva, Obstrucción del tracto urinario, Uropatía obstructiva |
| Japanese | 尿路閉塞症、詳細不明, 尿路閉塞ＮＯＳ, 尿路閉塞, 閉塞性尿路疾患, ﾆｮｳﾛﾍｲｿｸNOS, ﾆｮｳﾛﾍｲｿｸｼｮｳｼｮｳｻｲﾌﾒｲ, ﾍｲｿｸｾｲﾆｮｳﾛｼｯｶﾝ, ﾆｮｳﾛﾍｲｿｸ |
| Czech | Blíže neurčená obstrukce močového ústrojí, Obstrukce močového ústrojí NOS, Obstrukční uropatie, Obstrukce močového ústrojí |
| Hungarian | obstructiv uropathia, húgyúti obstructio k.m.n., húgyúti obstructio, Húgyúti obstructio, nem meghatározott, Obstructiv uropathia |
Ontology: Urinary outflow obstruction (C0600039)
| Concepts | Anatomical Abnormality (T190) , Disease or Syndrome (T047) |
| SnomedCT | 252028009 |
| English | Urinary outflow obstruction, Urinary outflow obstruction (disorder) |
| Spanish | obstrucción del flujo urinario (trastorno), obstrucción del flujo urinario |
Ontology: Postrenal failure (C1167727)
| Concepts | Disease or Syndrome (T047) |
| French | Défaillance sous-rénale |
| Italian | Insufficienza post-renale |
| Japanese | 腎後性腎不全, ｼﾞﾝｺﾞｾｲｼﾞﾝﾌｾﾞﾝ |
| Czech | Postrenální selhání |
| Hungarian | postrenalis veseelégtelenség |
| English | Postrenal failure |
| Portuguese | Insificiência pós-renal |
| Spanish | Fallo postrenal |
| Dutch | postrenaal falen |
| German | postrenales Nierenversagen |
Ontology: Postrenal azotemia (C2919641)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 445612002 |
| English | Postrenal azotaemia, Azotaemia due to urinary tract obstruction, Postrenal azotemia, Azotemia due to urinary tract obstruction, Postrenal azotemia (disorder) |
| Spanish | azoemia por obstrucción del tracto urinario, azoemia posrenal (trastorno), azoemia posrenal |
