Index
Ectasia comes from the Greek word “ektasis”, which means dilation.
Ectasia is defined in clinical terms as the dilation of a hollow or cylindrical organ.
When we refer to renal ectasia, it is only the dilation of the cavities of the kidney, which may be the renal pelvis or the kidney chambers, known as renal calyces.
The renal pelvis is a funnel-shaped tubular organ, this dilated area is located near the ureter of the kidney.
The renal pelvis acts as a collector of urine that is produced in the kidneys, to be transported to the ureter or tube that connects the kidney with the bladder, and then be expelled to the outside.
It is a renal morphological anomaly that together with cardiac abnormalities are more frequent and detectable by means of an ultrasound.
Although it is not a disease or pathology, but an alteration of the shape of the kidney cavities.
This imperfection, however, can be the beginning of an obstructive process of the urinary tract, which can degenerate into a renal disease.
As a consequence, it can produce eventual complications, which suppose an evaluation of the specialist doctor.
Function of the renal pelvis
The pelvic cavity or renal pelvis is located in the center of the kidney is a cavity or bag, where urine is deposited, with a funnel, connected to the bladder by means of the ureters.
If they are blocked or their vessels are constricted, they can not perform their function properly.
This obstruction produces an accumulation of urine in the renal pelvis and produces a dilation of the muscles.
This causes a reduced production of urine that can cause infections in the urinary tract.
Causes of renal ectasia
This anomaly, occurring in the formation of the fetus, is associated with the hormones of the mother that are present in the placenta.
It is believed that renal ectasia may be caused by a relaxation of the smooth muscle of the urinary tract due to the following factors:
- An increase in fetal diuresis.
- Malfunction of the fetus bladder.
- High consumption of alcohol by the mother during pregnancy.
Diagnosis
The diagnosis of renal ectasia can be evaluated at 20 weeks of pregnancy, since with the ultrasound technique you can examine the size, texture and position of the kidneys, you can also see the collection system and the ureters.
This anomaly can occur in 5% of the fetuses and its appearance is more frequent in the left kidney and in the male fetuses than in the female fetuses.
When the size of the dilation is greater than 4 mm in fetuses under 33 weeks and in fetuses over 33 weeks of gestation, greater than 7 mm then we can consider it as a renal ectasia.
When the dilation is greater than 13 mm, it is necessary to perform an ultrasound after the birth of the baby.
If the diagnosis is confirmed, it is recommended to prevent an infection with the administration of low doses of antibiotic to the newborn.
A study of serial voiding cystourethrography (VCUG) should be performed to verify if the ectasia is accompanied by a vesicoureteral reflux (VUR).
Kidney ectasia in children and adults should be monitored and in adulthood and be evaluated appropriately.
If this anomaly was not diagnosed during pregnancy, it can only be detected in case of symptoms of urinary tract diseases associated with this anomaly.
Diagnostic tools include tomography, magnetic resonance and ultrasound.
In the diagnosis, the appearance of symptoms must be evaluated and a kidney disease of complications due to alterations of morphological type, such as renal ectasia, must be ruled out.
symptom
The symptoms of renal ectasia are:
• Pain in the renal or pelvic line
Especially if the production of urine exceeds the flow rate in the clogged area, causing the volume of urine to decrease or stop completely.
• Fever
This anomaly can produce obstruction and depending on the severity of the obstruction, vesical – urethral reflux can occur towards the ureter and the kidney, causing infections.
Types and Treatment
Several types are observed according to the degrees of dilatation:
- Light.
- Moderate
- Severe
In most cases of renal ectasia, it is only a compromised urinary system, this anomaly remains stable over time or is exceeded in the neonatal stage.
Only in a range of 15% to 20% of the patients can obstructions in the urinary tract or vesico-ureteral reflux appear that will require exhaustive follow-up.
If the renal ectasia is greater than 20 mm, it is hydronephrosis, and then another type of management is necessary, which may be accompanied by surgery, endoscopy or medication therapy.
