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Hydronephrosis is swelling of the kidneys, and it occurs in about one percent of all infants. Through today’s precise ultrasound technology, infants can be diagnosed with hydronephrosis while they are still in the uterus (prenatal). If your baby is diagnosed with hydronephrosis while you are pregnant, chances are good that the condition will go away on its own before or shortly after delivery (post-natal).
Boys have hydronephrosis four to five times more often than girls, but so far, no other risk factors have been found. This means there is nothing you can do to protect your unborn child from hydronephrosis because it is not a hereditary condition.
For unknown reasons, hydronephrosis sometimes happens through normal physiologic development. At least half the time, it is benign and causes no issues. The most common causes for moderate to severe hydronephrosis are:
As one of the nation’s top-ranked pediatric urology programs, Riley at IU Health has physicians and nurses who are expertly qualified to diagnose and treat hydronephrosis.
Your child’s symptoms may vary based on the severity of his or her condition.
Hydronephrosis can be categorized as mild, moderate or severe, depending on the degree of swelling in the kidneys and how well urine flows. Infants seldom show symptoms of hydronephrosis, regardless of severity. Similarly, older children may not have symptoms if they are only mildly affected.
Children who have moderate to severe hydronephrosis may have:
It is important to follow up with a physician if your child has any of these symptoms.
When hydronephrosis is diagnosed after birth (post-natal), it is usually found after repeated urinary tract infections (UTIs) and/or fevers. If your child has this history, an evaluation by one of our pediatric urologists can determine whether the cause is an obstruction or an underlying difference in his or her anatomy.
We may use one or more tests to diagnose children and decide whether treatment is appropriate. Here are the tests we use most frequently:
Some tests are more invasive than others and may require your child to have a catheter and an IV. Child life specialists at Riley at IU Health can help your child cope with these procedures, using calming techniques, toys and other diversions.
It is very rare for an unborn child to need treatment for hydronephrosis. If your baby is diagnosed with hydronephrosis during your pregnancy, you will be monitored closely to make sure your baby has enough amniotic fluid, which is important for growth and development. Your baby’s hydronephrosis is unlikely to affect your pregnancy or delivery.
Within the first few weeks of life, some physicians may start your child on a small dose of antibiotic before a more thorough evaluation. Children with hydronephrosis caused by an underlying anatomy or obstruction may need surgery and/or lifelong follow-up care to protect kidney function.
These corrective surgeries are well-established procedures with good track records of success. Most children who have surgical treatment for hydronephrosis lead normal, healthy lives.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This organization focuses on awareness, prevention and treatment of kidney disease. Their website includes information about hydronephrosis in children.
This institute is part of the U.S. Department of Health and Human Services and supports medical research through universities and medical institutions in the U.S. It also provides health information about diabetes, digestive and kidney disease.