Nephroptosis, is rare and abnormal condition in which the

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...

drops down into the pelvis when the patient stands up. It is more common in women than in men. It has been one of the most controversial conditions in terms of both its diagnosis and its treatments.

Symptoms and signs

Nephroptosis is asymptomatic in most persons. However, nephroptosis can be characterized by violent attacks of colicky flank pain, nausea, chills, hypertension,

hematuria Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine. “Gross hematuria” occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable w ...

and

proteinuria Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become foamy (although this symptom ma ...

. Persons with symptomatic nephroptosis often complain of sharp pains that radiate into the groin. Many persons also suggest a weighing feeling on the abdomen. Pain is typically relieved by lying down. It is believed that flank pain on standing that is relieved by lying down is due to movement of the kidney causing intermittent renal tract obstruction. The attack of

colic Colic or cholic () is a form of pain that starts and stops abruptly. It occurs due to muscular contractions of a hollow tube (small and large intestine, gall bladder, ureter, etc.) in an attempt to relieve an obstruction by forcing content out. ...

pain is called 'Dietl's crisis' or 'renal paroxysm'.

Cause

It is believed to result from deficiency of supporting inferior pararenal fasciae.

Diagnosis

Diagnosis is contemplated based upon patient symptoms. Diagnosis is confirmed during intravenous urography, by obtaining erect and supine films. The renal

DMSA scan A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid (DMSA) in assessing renal morphology, structure and function. Radioactive technetium-99m is combined with DMSA and injected into a patient, followed by imaging with a gamma cam ...

may show decreased counts in the sitting position compared with supine scan.

Treatment

Nephropexy Nephropexy is the surgical fixation of a floating or mobile kidney (nephroptosis Nephroptosis, is rare and abnormal condition in which the kidney drops down into the pelvis when the patient stands up. It is more common in women than in men. It ha ...

was performed in the past to stabilize the kidney, but presently surgery is not recommended in asymptomatic patients. A Nephropexy does not guarantee the symptoms will go away. Laparoscopic nephropexy has recently become available for selected symptomatic patients.

References

External links