The kidneys are a paired organ, but nature admits that they are not always completely symmetrical. Expansion (or enlargement) of one of the kidneys may be a variant of the norm, or it may be a sign of pathology.
The reasons for an enlarged kidney in adults are often chronic diseases of the urinary tract, infections, structural and anatomical abnormalities, trauma, pregnancy.
If one kidney is one and a half to two times the size of the second, this is a reason to suspect problems and seek medical advice. After diagnosing and finding out the reasons for the enlargement of the kidney, the doctor will determine whether and what treatment is needed.
Basic parameters of a healthy kidney
The kidneys, like any internal organs, undergo changes with the growth of the human body. In a one-year-old child, this organ reaches a length of 6 cm, in adolescents it increases to 10 cm. Normal kidneys in women are 8-10 cm long and 4-5 wide.
The kidneys of men are usually a couple of centimeters longer and one wider. These are average values, the individual characteristics of the organism allow for an increase of 15-20%. The right kidney is not an exact copy of the left, a difference of 5% is considered normal.
From the age of fifty, irreversible atrophic changes in this organ are triggered. With age, the kidney decreases, both kidneys can descend, and the elasticity of blood vessels decreases. Age-related changes in kidney size also affect the size of the fat capsule.
In a very young child, it is almost absent, it gradually increases by the age of 50, then it begins to decrease, sometimes completely disappears. There are certain reasons for a sharp increase in the kidney.
An enlarged kidney does not always manifest itself clinically; a change in its size will only be revealed by ultrasound.
Sometimes, if the increase is impressive, an experienced doctor will determine it by palpation. But often the symptoms are still present, especially if the pathology is serious or the disease is neglected. Many patients with an enlarged kidney know well what renal colic is.
Recurrent sharp pain in the lower back means that the kidney may become enlarged in size and become diseased.
Reasons for an enlarged kidney
The following reasons for an enlarged kidney can be considered the main ones:
- hydronephrotic transformation,
- inflammatory disease
Hydronephrosis is the result of an enlarged renal chamber. Urine presses on her, which cannot go from the kidneys through the ureter to the bladder.
It is caused by abnormal changes in the urinary system, kidney stones, trauma, kidney tumors.
It is even possible that urine flows back into the kidney (reflux), triggered by an obstruction in the urinary tract. This is caused by an increase in the renal pelvis. Hydronephrosis can be mild (pyelectasis), moderate, or severe. With the third form of changes in the left kidney, right or both at once, it can lead to renal failure.
In infants, hydronephrotic transformations are usually caused by congenital abnormalities in the structure of the urinary tract and abnormalities in the development of their valves.
In older children, an enlarged kidney due to urinary retention can be caused by a narrowing of the lumen of the ureter, urethra. In adult patients, the cause of an enlarged kidney is a bacterial infection, renal stone pathologies, trauma to the urinary organs, neoplasms of a different nature.
Retention of urine in humans can cause inflammatory reactions of the genitals located near the kidneys. Typically, the female factor of urinary stagnation, provoking kidney expansion, is the intake of hormonal drugs.
Infectious and inflammatory diseases of the kidneys – pyelonephritis, glomerulonephritis – can lead to a change in this organ in size.
Infection with an infection leads to edema of the kidney tissue, as a result of which it increases in size. The infection can enter the organ from the urinary tract. Urogenital tract infections are more common in women. This is due to the shorter urethra, which makes it easier for infections to reach the bladder.
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Kidney stone disease as the reason for an enlarged kidney is more often diagnosed in men. This pathology is called “urolithiasis”.
It also occurs in young children. The formation of kidney stones is facilitated by poor quality water, unhealthy diet, lack of mobility in humans, living in hot climates, hereditary predisposition. Sometimes the causes of urolithiasis are inflammatory processes in the kidneys or abnormalities in the structure of the genitourinary organs.
One kidney can become larger than the other in benign or malignant tumors. Cysts, polyps, hemangiomas lead to a change in the size of the kidneys. Growing up, tumor formations interfere with normal urination, the organ increases in size.
If there are no more than two cysts in the kidney, it is not so dangerous. Multiple fluid-filled cysts, or polycystic kidney disease, are the fourth most common cause of kidney failure. Polycystic disease is often hereditary.
With hypoplasia, one kidney remains smaller than the other due to its lag in development or congenital pathology that develops in the kidney in a child even during intrauterine development
At the same time, the structure and functions of the organ’s cells are absolutely normal, but their number is about 2 times less than the norm.
Hypoplasia in most cases is unilateral and is more of a male pathology than female (approximately two cases to one).
The enlargement of the kidneys makes itself felt by renal colic – pain in the lower part of the lower back. But in the initial (latent) stage, this symptom may not be present. If the cause of the enlargement of the kidney is an inflammatory process, then an increase in body temperature is observed.
Disorders of the normal functioning of the organs of the gastrointestinal tract are almost always accompanied by kidney disease. Symptoms of pathology are manifested in the process of urination with a burning sensation and cuts in the perineum and pelvis.
The amount of urine excreted can change, decrease or increase, depending on the cause of the change in the size of the kidney. If the kidney or urinary tract is infected, blood may be present in the urine.
Only a specialist in diseases of these organs, a nephrologist, can accurately determine the causes of an enlarged kidney. Palpation allows you to determine the size of the kidneys and their location. The most common diagnostic method is ultrasound.
Ultrasound can confirm hydronephrosis and polycystic disease as a pathology that led to an increase in the diseased organ. To clarify the diagnosis, radiography, computed tomography, magnetic resonance imaging, cystoscopy can also be prescribed.
Blood and urine tests are informative. In the blood, the content of leukocytes, erythrocytes, and protein is determined. The content of creatinine, urea, nitrogenous compounds is determined in the urine – a deviation of their level from the norm indicates kidney disease. A bacteriological examination of urine is also carried out to identify the causative agent of the infection.
If the kidney is enlarged and the cause of this disorder is identified, the urologist will prescribe the necessary treatment. Therapy is usually based on three areas:
- Appointment of a diet.
- Drug treatment.
- Surgical intervention.
Diet restrictions reduce the stress on the affected organs and will help improve their functioning. In particular, for the treatment of urolithiasis, it is important to change the acidity of urine in order to facilitate the dissolution of calculi (stones) in the kidneys.
General recommendations require to do without fried, salted, smoked, fatty, canned food. The diet should not contain alcohol, soda with sugar, the use of cocoa and coffee is limited.
It is recommended to replenish the menu with vegetables, fruits, cereals, low-fat dairy products. Eating meat should also be limited, since when proteins are broken down, nitrogenous compounds are formed, which impede the functioning of the kidneys.
To treat an enlarged kidney with medication, they begin using antispasmodics and pain relievers to relieve pain and alleviate the general condition, as well as speed up the removal of stones if necessary.
Antibacterial agents are prescribed for the inflammatory process. The results of bacteriological analysis of urine will help to make the right choice of drug. Usually, treatment is carried out with broad-spectrum antibiotics.
They are taken for 7-14 days, even if the symptoms of inflammation are no longer bothering. The infection must be completely eradicated. Drink more water while taking antibiotics.
Herbal diuretics will help to normalize the excretion of urine and the output of calculi. But in the presence of kidney pathology, they should be used only after consulting a doctor. There are diseases in which diuretics are contraindicated.
In severe cases of blockage of the urinary tract, excess urine is removed using a catheter inserted into the bladder, through which urine flows out.
Symptomatic treatment is also carried out. If increased intrarenal pressure has led to hypertension, an ACE inhibitor is prescribed to normalize blood pressure.
The help of the surgeon is necessary if the change in the size of the kidney is caused by abnormalities in the structure of the organs of the urinary system. Indications for surgery are also large tumors, lack of results with drug treatment of pathology. The purpose of operations is to remove obstructions in the urinary tract.
Endoscopic surgery makes it possible to remove several problems at once. In case of narrowing of the ureter or heavy stone discharge during surgery, the problem is solved by installing stents or catheters.
If the expansion of the kidney is caused by a narrowing of the lumen of the ureter, it is excised during surgery.
They are widely used for the treatment of kidney stones by contact, remote and laser crushing of calculi. An alternative surgical technique is nephrostomy. With its help, urine is drained directly from the kidney.
At the current level of development of medicine, surgeons are trying to use reconstructive and organ-preserving methods of treatment.
The key to success in the treatment of kidney pathologies is treatment started in a timely manner, before irreversible violations in the functioning of the organ began. Otherwise, kidney damage and kidney failure may develop. In this case, only dialysis and transplantation can save the patient’s life.
It is important for the patient to know what he can do on his own if the kidney is enlarged. Preventive measures help to strengthen the organ that has lost its normal working capacity. In addition to a diet that includes maximum salt restriction, an active lifestyle and maintaining a normal weight are important.
Walking at a good pace or exercising will help improve blood circulation, which will affect the functioning of the urinary system. Both hypothermia and severe overheating are harmful to the kidneys. When overheated, the blood thickens, which increases the load on this organ. Hypothermia can lead to inflammation.
The kidneys are the most important organ that works 24 hours a day. They not only produce urine and excrete it through the urinary tract.
If your kidneys are healthy, they:
- remove waste products from the body, toxins,
- regulate acid-base balance,
- regulate blood pressure by producing hormones,
- by producing the hormone erythropoietin, they control the production of blood cells in the bone marrow,
- affect the concentration of calcium and the formation of vitamin D in the blood.
Kidney disease can impair any of these functions, compromising a person’s health and quality of life. Keeping these organs in working order, preventing an increase in their size is an important task that can be solved by early diagnosis and following the advice of a specialist.