Congenital pathology of internal organs in this time is not a rare occurrence. Urinary tracts are no exception. One form of congenital anomaly is the medullary spongy kidney.
Spongy kidney
The name of the diagnosis speaks for itself - if you represent the diseased organ in a section, it will look like a fine sponge. The spongy kidney is a cystic abnormality and even in the international classification of diseases the diagnosis can be found by the code Q61 - "Cystic kidney disease".
Externally, the kidney is not changed at all - at the examination it is evident that the edges of the organ are even, color normal. Pathology is found in the Malpighian pyramids and kidney tubules. The tubules containing urine are significantly expanded, and the renal tissue itself is affected by minute formations - cysts having a size of 1 to 5 mm. There are cysts and larger sizes - up to 7.5 mm, and they are located closer to the center. Cysts are scattered throughout the surface of the pyramids, and their cavities are filled with sand and small stones. Most often the disease covers both organs and occurs mainly in males.
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Causes of pathology
A spongy kidney is a congenital disease, moreover, there are reliable data that the disease is hereditary. Nevertheless, it can not be said that the child will inevitably inherit from the parent this pathology.
Scientists associate the development of cystic formations in the kidney tissue with malfunctions in the development of the embryo in the womb of the mother, and the expansion of the renal tubules - with violations that occur after the birth of the baby.
Symptoms of
In children, the medullary spongy kidney does not manifest itself in any way, the disease proceeds latently and is detected either in the development of complications or becomes an accidental finding in the study of the kidneys.
Most often the disease manifests itself in patients aged 40 to 50 years following manifestations:
- hematuria - the presence of blood in the urine;
- pyuria - detection in urine of pus;
- dysuria - a violation of the process of urine output;
- renal colic, which occurs in case of penetration of stones in the pelvis or calyx;
- constant aching pain in the lumbar region;
- increase in body temperature on the background of an infection
This symptomatology indicates that the congenital pathology was joined by a urinary tract infection. Sometimes a doctor may suspect the presence of a spongy kidney in a patient with a prolonged recurrent stone formation. In case of secondary infection or the penetration of stones into the cavity of the renal pelvis, its function is impaired, which requires constant medical control and urgent hospitalization.
More than half of all patients diagnosed with "medullary spongy kidney" have concomitant nephrocalcinosis of the papillae, which manifests itself in a large number of minute calculi common in the kidney parenchyma, which is clearly seen on the radiograph.
Diagnostics of
In addition to the traditional renal ultrasound, which, incidentally, is not always informative in the case of such a diagnosis, the patient must undergo a series of studies helping the doctor to determine exactly whether the cystic kidney formation is medullaryspongy kidney.
Survey includes:
- Excretory urography as the main method for diagnosing a spongy kidney. With the introduction of contrast agent in the structure of the kidneys, cystic cavities in the form of bunches and enlarged tubules are clearly visible.
- Radiography. This type of study is mainly used in the presence of concrements or complications in the form of nephrocalcinosis.
- Computerized tomography used to select the site where tissue will be taken for histological examination, as well as for possible surgical intervention to perform postoperative monitoring.
- Blood and urine tests to help identify pyuria, hematuria, hypercalciuria.
Treatment of
Given the fact that the disease has not been manifested for many years, treatment of such a pathology is usually not carried out. Even with an accidental finding in the patient of anomalies in the structure of the kidney, nephrologists usually do not prescribe any therapeutic treatment.
Therapy is performed only when complications such as pyelonephritis, stone formation, cystitis, etc. are added.
In this case, the doctor will recommend compliance with the drinking regime( intake of a large amount of purified water during the day), a diet low in calcium, and taking diuretics - thiazides. All patients with such complications should definitely be monitored by a nephrologist and immediately hospitalized if renal colic occurs.
When joining infections of the urinary system, doctors generally adhere to standard treatment protocols. Surgical treatment of this pathology is not shown.