When Your Child Has Hydronephrosis

Normal kidney and ureter connected to bladder. Kidney enlarged because of narrowed part in ureter near kidney. Kidney and ureter enlarged because of narrowed part of ureter near bladder.

One or more of your child’s kidneys is enlarged because of urine backup. This is called hydronephrosis. The problem may have been diagnosed before your child was even born. Often the condition is not serious. In fact, in many children the problem goes away with time. In some cases, treatment is needed. Your child’s healthcare provider can tell you about treatment options. Your child may see a pediatric urologist. This is a doctor who manages problems of the urinary tract in children.

What is hydronephrosis?

Hydronephrosis is swelling of a kidney due to a backup of urine. It may be mild, moderate, or severe.

What causes hydronephrosis?

There can be several causes of urine backup. There may be a blockage in the urinary tract that does not let urine flow normally. Urine may flow the wrong way (reflux) back up to the kidneys. Or urine may drain too slowly down from the kidneys. These problems can lead to a swollen kidney and may cause lifelong (permanent) damage to the kidney. Tests can be done to find the cause of your child's condition. The healthcare provider will tell you more. In rare cases, the blockage may be in the kidney itself.

How is hydronephrosis diagnosed?

A swollen kidney may be seen on ultrasounds done during pregnancy. Once the baby is born, he or she may have a test to confirm hydronephrosis. This test is called a kidney (renal) ultrasound. Urine that does not flow normally can lead to a urinary tract infection (UTI). A renal ultrasound test may be done if a baby or child has a UTI.

How is hydronephrosis treated?

Treatment depends on the cause of the urine backup. It also depends on how bad the problem is. A mild problem may go away on its own without treatment. If the problem was found with prenatal ultrasound, treatment may wait until the baby is born. The goal of treatment is to protect the child’s kidneys as he or she grows. Your child’s healthcare provider can talk with you about how best to treat your child. Your child may need:

  • Follow-up ultrasounds to check kidney health

  • Surgery to improve urine flow if the problem is severe

What are the long-term concerns?

A mild case of hydronephrosis may cause no problems. But a severe case or one that gets worse can lead to kidney damage. Your child’s condition will be watched closely. If needed, treatment can be done to prevent long-term problems.