Hydronephrosis (swelling and urine retention) in one kidney occurs in about one in 100 people. There’s also some evidence that about two percent of all prenatal ultrasound examinations reveal some degree of hydronephrosis, making it “one of the most commonly detected abnormalities in pregnancy.” (1)
Things that put you at risk for hydronephrosis include: having kidney stones, scarring in your urinary system due to past surgeries or infections, frequent UTIs, history of bladder or colon cancer or increased pressure in your pelvis due to pregnancy. Anatomical defects can also cause this condition in babies or unborn fetuses.
In most cases, with treatment hydronephrosis will resolve and the kidneys will resume their normal function. Sometimes the condition even clears up on its own, although not always. It’s important for severe hydronephrosis to always be treated promptly in order to reduce the risk for potential complications — like permanent kidney damage or kidney failure. Treatments for hydronephrosis typically include use of antibiotics or pain-relieving medications … or sometimes surgery.
What are some natural ways you can improve recovery from hydronephrosis and support kidney health? Eating a healthy diet, staying hydrated, dulling pain with a warm compress and preventing UTIs and kidney stones are all beneficial for managing hydronephrosis symptoms.
What Is Hydronephrosis?
Hydronephrosis refers to excess fluid that builds inside a kidney (swelling) due to a backup of urine. (2) The condition can affect one kidney or sometimes both; unilateral hydronephrosis describes one kidney being affected, while bilateral hydronephrosis describes both being affected. It’s most common for hydronephrosis to cause dysfunction of one kidney, which fortunately means that the other kidney can do the work for both. Sometimes reverse flow of urine also occurs, which is called reflux.
The kidneys are small, bean-shaped, fist-sized organs that sit in the middle of your back below your rib cage. The kidneys connect to the urinary tract, including the two ureters, bladder and urethra. Their role in the body includes draining waste, excess fluids and urine from the body.
Both adults and children, even infants and unborn fetuses, can develop hydronephrosis if urine is not able to leave the body properly. Hydronephrosis is more often seen in males than females, but both sexes can be affected.
How do you know if something is wrong with your kidneys? Hydronephrosis doesn’t always cause noticeable symptoms, which means it can sometimes be ignored or overlooked until it becomes a more significant problem. Pain over the kidneys, tenderness in the back and abdomen and changes in urination are some signs there may be a problem with your kidneys.
Signs and Symptoms
When they do occur, what are the symptoms of a blocked kidney? (3) The most common hydronephrosis symptoms include:
- Pain near the kidneys, which are located against the back muscles in the upper abdominal area. Pain may be felt on the side of the body and the back (this is sometimes called flank pain)
- Pain when urinating
- Urgent or frequent need to urinate
- Blood in the urine
- Abdominal or groin pain
- Nausea and vomiting
- Increased abdominal mass and swelling
- Urinary tract infection
- In infants, increased fussiness, crying and “failure to thrive”
Symptoms depend on whether hydronephrosis is mild, moderate or severe. Moderate or severe hydronephrosis that is not treated can sometimes become very serious and lead to complications including permanent kidney damage or even kidney failure (although failure is rare).
Can hydronephrosis cause high blood pressure? It doesn’t happen very frequently, but sometimes hydronephrosis can lead to hypertension (high blood pressure), especially in the elderly. Researchers believe this happens due to factors like vasoconstriction (constriction of blood vessels) and salt and water overload. (4)
Hydronephrosis is different than the condition called nephrosis (or nephrotic syndrome), which is a type of kidney disease characterized by edema and the loss of protein from the blood into the urine. In adults, the most common cause of nephrosis is diabetes, while other causes can include amyloidosis, multiple myeloma, lymphoma, preeclampsia, systemic lupus and HIV. (5) Both hydronephrosis and nephrosis can cause swelling of the kidneys, but nephrosis is different because it also involves too much protein being excreted into the urine, resulting in symptoms like malnutrition, muscle wasting and others. Nephrotic syndrome can also increase your risk of infections and blood clots.
Hydronephrosis Causes and Risk Factors
What causes hydronephrosis? Most often hydronephrosis occurs because there’s a blockage in the tubes that drain urine from the kidneys (called the ureters). The ureters normally take urine from the kidneys and bring them to the bladder so the urine can be removed from the body.
Sometimes there will be a partial blockage in the urinary tract where the kidneys and ureter meet (called the ureteropelvic junction), or there can be a blockage where the ureter meets the bladder (called the ureterovesical junction). Blockages trap urine in the kidney, causing it to build up and stretch. When the ureter becomes dilated, this is called hydroureter.
Vesicoureteral reflux happens when urine flows backward through the ureter from the bladder up into the kidney. Vesicoureteral reflux is graded according to the degree of reflux: in mild cases, urine backs up only to the ureter (grade I or 1) and in severe, kidney swelling (hydronephrosis) and twisting of the ureter occur (grade V or 5). (6)
What can cause inflammation of the kidneys and kidney dysfunction? Hydronephrosis is not a disease itself, but rather a side effect caused by other diseases, injuries, infections or conditions. Causes of urine backing up in the kidneys or ureters can include: (7)
- An anatomical defect, or congenital blockage (a defect that is present at birth)
- Scarring of the ureter caused by prior infections, surgeries or radiation treatments
- Kidney stones
- A tumor in the abdomen or pelvis, which can sometimes be cancerous. For example, hydronephrosis can occur in patients with bladder cancer. It may be caused by tumor at the ureteral orifice or other ureteral tumors that cause compression of the ureter (8). Cervical, colon or prostate cancer tumors can also lead to hydronephrosis
- Enlarged prostate
- Problems with nerves that lead to the bladder
- Blood clots
- Inflammation and infection of (or near) the kidneys
- In women, blockage from an enlarged uterus during pregnancy
- Uterocele, or the lower part of the ureter protruding into the bladder
- Not being circumcised. Researchers now hypothesize that boys with an early diagnosis of hydronephrosis who undergo newborn circumcision will have reduced rates of UTI. A recent study that appeared in the journal Pediatrics and was released by the American Academy of Pediatrics found that circumcision was associated with a reduced risk of UTI for those with isolated hydronephrosis, vesicoureteral reflux and ureteropelvic junction obstruction. (9)
Is hydronephrosis genetic? It can be. Normally hydronephrosis is not genetic and is not hereditary. However, it’s possible for hydronephrosis to occur due to a genetic defect that causes obstruction of the ureter. Hereditary hydronephrosis is considered an autosomal dominant trait that causes unilateral or bilateral pelvi-ureteric junction (PUJ) obstruction. (10) Certain genetic conditions can cause the kidneys to develop cysts, increasing the chance of a blockage occurring.
Diagnosis and Conventional Treatment
How is hydronephrosis diagnosed? Your doctor or a urologist (who specializes in conditions that affect the urinary system) can make a diagnosis of hydronephrosis by performing a physical examination and a number of tests.
Tests might include: blood test, urine test to check for signs of infection or a blockage, ultrasound imaging exam to view the kidneys, voiding cystourethrogram/X-ray exam to observe the kidneys, ureters, bladder and urethra and potentially other tests such as computerized tomography (CT) scan, magnetic resonance imaging (MRI) or MAG3 scan to evaluate how the kidneys are functioning. An ultrasound can detect structural abnormalities that may lead to hydronephrosis in infants or unborn fetuses. This test can also be used to reveal swollen kidneys in an unborn baby and primary vesicoureteral reflux (the backward flow of urine).
Sometimes mild hydronephrosis will resolve on its own and not require any treatment. But if the condition has become more moderate or severe, then treatment is needed to get rid of any blockage and restore function of the affected kidney(s). Treatment for hydronephrosis will typically involve:
- Sometimes a “wait-and-see approach” is utilized, which is when nothing is done while the condition is monitored for a period of time. This is recommended for mild to moderate hydronephrosis, but not if the condition is severe.
- Sometimes antibiotics will also be given to help prevent spreading or worsening of a urinary tract infection (UTI). Antibiotics can keep the infection from moving to the kidneys. This is especially important in people who have only one kidney or who have immune system disorders, such as diabetes or HIV.
- Analgesics or over-the-counter medications may be used to relieve pain.
- Surgery may be recommended to eliminate a blockage, but usually this is only needed in severe cases. A procedure can also be performed for vesicoureteral reflux to repair the defect in the valve between the bladder and ureter, preventing urine from flowing the wrong direction. Surgery options include: open surgery that is performed under general anesthesia and involves an incision in the lower abdomen, robotic-assisted laparoscopic surgery that uses a smaller incision to repair the valve between the ureter and the bladder or endoscopic surgery, which involves a tube (cystoscope) being inserted through the urethra and a bulking agent being injected to strengthen the valve’s ability to close. (11)
- If kidney failure occurs, dialysis or a kidney transplant may be needed.
5 Natural Ways to Manage Hydronephrosis Symptoms and Prevent Them
1. Stay Hydrated
Drinking plenty of water and fluids helps to dilute urine and flush out bacteria from the urinary system. Aim to drink at least eight glasses of water per day, such as by having a glass every hour or so while you’re awake. If your baby or child is affected by hydronephrosis, encourage them to drink more fluids by making them freshly squeezed juice, ice pops or chilled herbal tea; however, you and your child should avoid juices and soft drinks containing citrus and caffeine since these can irritate the bladder and make pain worse.
2. Reduce Pain Associated with Swelling
If you’re dealing with pain around your abdomen or back, try applying a warm compress, such as a heating pad or warm, damp towel. You can prepare a warm towel or blanket by placing one in the dryer for a few minutes. Gently apply the towel over the abdomen for about 15 minutes, several times daily, or whenever needed. Just make sure the towel/compress is not very hot so it doesn’t burn the skin.
3. Avoid Holding In, Constipation and Straining
Try to urinate about every two hours, or more as needed. Don’t hold in urine, which can make discomfort worse.
Constipation can also make pain and swelling in the abdomen worse, so take steps to prevent it by:
- Eating enough fiber, such as from high fiber foods like: a variety of fresh vegetables and fruit, nuts, seeds, soaked legumes/beans, avocado and coconut.
- Drinking enough fluids
- Staying active as much as possible, such as by doing gentle exercises like walking or stretching
- Getting enough sleep and managing stress
- Taking a magnesium supplement if needed before bed, in order to help loosen stool and relax muscles in the pelvis (to be safe, check with your doctor first before beginning any new supplement)
- Consuming chia and flax seeds soaked in water, which absorb fluid to form a gel-like consistency that helps lubricate stools
- Using aloe vera gel or pysillium husk
4. Help Prevent Kidney Stones
You’re at a greater risk of developing kidney stones if you take diuretics (which can lead to dehydration), have a history of chronic urinary tract infections, gout, hyperthyroidism and trouble digesting minerals normally or are very inactive.
You’re less likely to develop kidney stones if you eat a healthy diet that is alkalizing and low in oxalates. (12) Here are some of the top foods for supporting kidney health and helping prevent kidney stones:
- Fresh vegetables and fruit — Some research shows that people who follow a mostly plant-based diet, low in dairy products and meat, tend to have fewer kidney stones. Good choices include: bananas, leafy greens of all kinds (and fresh-squeezed veggie juice), sprouted legumes, sprouted grains, fish and small amounts of pasture-raised poultry.
- Vitamin E-rich foods — Berries, olive oil, almonds, avocado and butternut squash
- Alkaline foods — Lemon juice, apple cider vinegar, raw honey, green smoothies, sea veggies and fresh vegetables
- Magnesium and potassium-rich foods — Leafy green veggies, cruciferous veggies, melon, bananas, cocoa and avocado for example
- Sprouted grains (as opposed to refined grain products) — Sprouting grains reduces their antinutrient content, making their nutrients more digestible.
Make sure to reduce consumption of processed and refined foods. Limit or avoid: sugary foods and sweetened drinks, unsprouted grains or refined grains, foods naturally high in oxalic acid (these include: spinach, rhubarb, tomatoes, collards, eggplant, beets, celery, summer squash, grapefruit/grapefruit juice, sweet potatoes, peanuts, almonds, blueberries, blackberries, strawberries and parsley), processed meats and cold cuts, too much vitamin C and zinc, caffeine and alcohol.
It’s also important to stay hydrated. Supplements that can help reduce kidney problems include magnesium, B vitamins, cranberry extract, aloe vera juice/gel and essential oils such as lemon, orange, lime or helichrysum essential oil. Additionally, if your doctor feels you’re at a high risk of complications due to kidney stones, he or she might recommend you take medications that can help prevent them.
5. Reduce Your Risk for Severe UTIs
Below are tips that may help prevent UTIs, or keep them from worsening and spreading:
- Practice safe sex. Limit the number of partners you have, use protection and urinate shortly after.
- Visit your doctor regularly for annual check ups, including pap smears or urine tests. Always report any UTI symptoms promptly, like pain or burning sensations.
- Take a probiotic supplement daily and eat probiotic-rich foods.
- Drink plenty of fluids.
- Urinate often, which helps to flush out bacteria that may have entered the urethra.
- Wipe properly, from front to back, especially after a bowel movement. This ensures that bacteria doesn’t get into the urethra.
- Wear loose-fitting clothing and underwear to keep the urethra dry and allow for air flow. Avoid wearing tight jeans or material like nylon that can trap air and bacteria.
- Drink fresh cranberry juice.
- Consume garlic regularly, or take garlic capsules.
- Use clove, myrrh and oregano essential oils to help improve UTI symptoms.
If you or your child are being treated for hydronephrosis, including if you’re taking antibiotics or other medications, it’s important to be monitored regularly and to visit your doctor for physical exams and urine tests. This can help to detect infections in their early stages and prevent complications from occurring.
Your doctor will likely want to perform bladder and kidney exams periodically to determine if the condition is improving or if vesicoureteral reflux if worsening. Make sure you understand how often you or your child should be examined in order to prevent kidney damage and other serious problems from developing.
- Hydronephrosis refers to excess fluid that builds inside a kidney (swelling) due to a backup of urine. This usually affects only one kidney, but can sometimes affect both.
- Pain over the kidneys, tenderness in the back and abdomen, changes in urination, UTIs, fever and bloody urine are some signs that there may be a problem with your kidneys.
- Risk factors for hydronephrosis include: being male, family history/genetic factors, kidney stones, history of cancer that affects the urinary system, blood clots, enlarged prostate and others.
- Conventional treatments for hydronephrosis include “watching and waiting” (mild cases), antibiotics, pain-reducing medications and sometimes surgery.
- To help take care of your kidneys and manage hydronephrosis symptoms, natural remedies include: staying hydrated, eating a nutrient-dense diet, urinating frequently, preventing constipation and preventing UTIs and kidney stones by practicing safe sex, taking beneficial supplements and more.