Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
Hydronephrosis in Child
Other Resources UpToDate PubMed

Hydronephrosis in Child

Contributors: Casey Silver MD, Abhijeet Waghray MD, Catherine Moore MD, Eric Ingerowski MD, FAAP
Other Resources UpToDate PubMed

Synopsis

Hydronephrosis is dilation of the renal pelvis and calyces due to obstruction of urinary flow. This obstruction may occur anywhere along the urinary tract. Increased ureteral pressure leads to changes in glomerular filtration rate, tubular function, and renal blood flow. The obstruction may be acute or chronic, and unilateral or bilateral.

In children, hydronephrosis is most often secondary to an anatomic abnormality such as posterior urethral valves, vesicoureteral reflux, or ureteropelvic junction (UPJ) obstruction. Congenital anomalies account for a higher incidence of hydronephrosis in children compared to adults.

The Society for Fetal Urology (SFU) has developed a grading system for the severity of hydronephrosis. Severity ranges from grade 0 (mild; no renal pelvis dilation) to grade 4 (severe; dilation of the renal pelvis and calyces and thinning of the renal parenchyma).

Patients with isolated hydronephrosis are typically pain free; the presence of pain is usually in the setting of stones, acute bladder distension, or infection. Upper ureteral or renal pelvic lesions typically cause flank pain, whereas lower ureteral obstruction causes pain that radiates to the ipsilateral testicle or labia. Other presenting symptoms include hypertension, change in urine output, hematuria, or new creatinine elevation on routine laboratory studies.

Codes

ICD10CM:
N13.30 – Unspecified hydronephrosis

SNOMEDCT:
43064006 – Hydronephrosis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Subscription Required

References

Subscription Required

Last Reviewed:10/14/2019
Last Updated:11/21/2019
Copyright © 2024 VisualDx®. All rights reserved.
Hydronephrosis in Child
Imaging Studies image of Hydronephrosis - imageId=8359154. Click to open in gallery.  caption: '<span>Transverse grayscale ultrasound image of the left kidney demonstrates moderate to severe hydronephrosis.</span>'
Transverse grayscale ultrasound image of the left kidney demonstrates moderate to severe hydronephrosis.
Copyright © 2024 VisualDx®. All rights reserved.