Nephroptosis

Nephroptosis
Specialty	Urology, Nephrology

Nephroptosis (also called floating kidney or renal ptosis) is an 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 has been one of the most controversial conditions among doctors in both its diagnosis and its treatments.^[1]

Symptoms

Nephroptosis is asymptomatic in most patients. However, nephroptosis can be characterized by violent attacks of colicky flank pain, nausea, chills, hypertension, hematuria and proteinuria. Patients with symptomatic nephroptosis often complain of sharp pains that radiate into the groin. Many patients also suggest a weighing feeling on the abdomen. Pain is typically relieved by lying down ( flank pain on standing that is relieved on lying down, the probable cause to pain is that movement of the kidney causes intermittent renal tract obstruction ). The attack of colic pain is called 'Dietl's crisis' or 'renal paroxysm'.

Cause

It is believed to result from deficiency of supporting 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 may show decreased counts in the sitting position compared with supine scan.

Treatment

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

References

Further reading

• Barber N, Thompson P (2004). "Nephroptosis and nephropexy--hung up on the past?". Eur Urol. 46 (4): 428–33. doi:10.1016/j.eururo.2004.03.023. PMID 15363554.

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