Neonatal Hydronephrosis

WHAT YOU SHOULD KNOW:

• Neonatal (neo-NA-tal) hydronephrosis (hi-dro-ne-FRO-sis) is a condition affecting the kidneys among newborns. This occurs when the baby's urine does not drain properly into the bladder. When this happens, the urine gets trapped and overfills the kidneys. The collecting part of the kidneys begins to stretch and enlarge (get bigger). This then leads to pain, bleeding, or frequent infections, which may further damage your baby's kidneys. Mild neonatal hydronephrosis may resolve before your baby reaches the age of one year. A blockage or reflux (backing up) of urine flow in the urinary tract may cause neonatal hydronephrosis.
  
  
• Signs and symptoms of neonatal hydronephrosis may include trouble passing urine or having a pinkish to reddish-colored urine. Your baby may also have a fever or abdominal (belly) pain. Neonatal hydronephrosis may be detected even before your baby is born by a fetal ultrasound or urine tests. Other tests may also be done after he is born. These may include intravenous pyelogram (IVP), a kidney scan or ultrasound, or voiding cystourethrogram (VCUG). Treatment may include medicines to ease his symptoms, placing a catheter or shunt, or surgery. The earlier neonatal hydronephrosis is found and treated, the better the chances that your baby may live. With proper treatment and follow-up, your baby's symptoms may be relieved and his quality of life may be improved. Ask your caregiver for more information about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.

RISKS:

Treatment for neonatal hydronephrosis may cause unpleasant effects. Some medicines may cause nausea (upset stomach), vomiting (throwing up), drowsiness, skin rash, or other kidney problems. Your baby could get an infection or bleed too much with surgery. If left untreated, the toxic waste products not removed may cause sepsis (blood infection) or kidney failure. This may lead to more serious and often life-threatening problems, such as heart, liver, or brain damage. The earlier neonatal hydronephrosis is found and treated, the better the chances that your baby may survive. Ask your child's caregiver if you are worried or have questions about his condition, care, or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Foley catheter:

This is a tube that may be put into your child's bladder to help drain his urine into a bag. The bladder is an organ where urine is kept. A foley catheter is usually placed before surgery and taken out shortly after the surgery.

Intake and output:

Caregivers may need to know how much liquid your child is getting and urinating. Your child may need to urinate into a container in bed or in the toilet. A caregiver will measure the amount of urine. If your child wears diapers, a caregiver may need to weigh them. Do not throw away diapers or flush urine down the toilet before asking a caregiver.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Medicines:

Your baby may need any of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Ibuprofen or acetaminophen: These medicines are given to decrease your child's pain and fever. They can be bought without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it.

Tests:

Your baby may need any of the following:

• Blood and urine tests: Samples of your baby's blood or urine are collected and sent to a lab for tests.
  
  
• Imaging tests:
  
  
  • Abdominal or renal ultrasound: This is a test using sound waves to look at your baby's abdomen (belly), kidneys, and other organs. Pictures of his kidneys show up on a TV-like screen.
    
    
  • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your baby's abdomen and urinary tract.
    
    
  • Intravenous pyelogram: This is also called an IVP. An IVP is an x-ray of the kidneys, bladder, and ureters. The IVP shows how well your baby's kidneys drain urine. Dye is put into his vein (IV) which makes these organs show up better in x-ray pictures. He may need to have more than one x-ray over short periods of time during his IVP.
    
    
  • Kidney scan: During this test, pictures are taken of your baby's kidneys. Your baby is given a small, safe amount of dye in an IV. Caregivers can look at the pictures to know how well his kidneys are working. This may also tell the cause of any blockage in his urinary tract and how bad it is.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your child's abdomen. During an MRI, pictures are taken of his urinary tract, muscles, or blood vessels. He will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.
    
    
  • Voiding cystourethrogram: This test is also called a VCUG. It is a special x-ray that checks your baby's urinary tract. A catheter (tube) is placed in the urethra (tube that drains urine from the bladder). The bladder is then filled with a liquid dye. X-ray images will be taken as the bladder fills and empties. The images will show if there is any back flow of urine into the ureters and kidneys and how well the bladder empties. It is also used to know if there is an obstruction in the urethra.

Treatment options:

Treatment for neonatal hydronephrosis aims to restore normal urine flow, relieve symptoms, and prevent serious problems. Caregivers may do surgery to remove a blockage so urine can drain to the bladder. A shunt may also be placed to help widen a narrowed part of your baby's urinary tract. Ask your caregiver about these treatment options.

Learn more about Neonatal Hydronephrosis (Inpatient Care)