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prolapse of the kidney; a condition in which the kidney is pathologically mobile.
Nephroptosis occurs most frequently on the right side. In nephroptosis, the kidney is displaced downward more than 2 cm when the body is in a vertical position and more than 3–5 cm when a deep breath is taken. Version around the axis of the vascular stem of the kidney is also possible. Organisms can be predisposed to nephroptosis by a decrease in muscle tone of the abdominal wall, severe weight loss, excessive physical labor, traumas, and congenital peculiarities in the structure of the vascular stem of the kidney and of the kidney bed. Nephroptosis develops most often in women; to a large extent, it can be caused by poor health habits during pregnancy and by difficulties during parturition.
There are three stages of nephroptosis. In the first stage, clinical manifestations can be completely absent or there can be neurasthenic complaints. In the second stage, pains appear in the lumbar region; these are intensified when the patient is in a standing position. The pains are occasionally paroxysmal. During this second stage, proteins and erythrocytes are often found in the urine. In the third stage the pain is further intensified, attacks of renal colic are more frequent, gastrointestinal disorders and headaches occur, and fatigue and irritability increase.
Radiopaque X-ray methods, isotopic renography, and radioisotopic scanning of the kidney play an important role in the diagnosis of nephroptosis. Treatment is determined by the stage of the disease: abdominal bandages and physical therapy, directed toward strengthening the muscles of the anterior abdominal wall, are employed in less severe cases; nephropexy, or surgical fixation of the kidney, is recommended in complicated cases of nephroptosis.
REFERENCERukovodstvo po klinicheskoi urologii. Edited by A. Ia. Pytel’ Moscow, 1969.
N. R. PALEEV