What is Nephroptosis?
Nephroptosis is a medical condition in which the kidney moves out of its normal anatomical position and descends to the pelvic region whenever the affected individual moves from supine position to upright. This condition is also referred to as floating kidney. This movement of the kidney results in a variety of symptoms like acute pain in the abdominal area, vomiting, and in some cases orthostatic hypertension.[1]
The diagnosis of Nephroptosis is normally made by evaluating the clinical symptoms, a detailed examination, and intravenous urography in which supine and erect images are obtained. These images clearly show a change in the position of the kidney thus confirming the diagnosis of Nephroptosis.[1]
Surgery is the primary mode of treatment of this condition and the procedure done for it is termed as nephropexy. However, this mode of treatment is now being debated as it does not always result in complete resolution of the symptoms even though this procedure is still being performed by some surgeons.[1, 2]
The term Nephroptosis was first stated in the late 19th century. Apart from abdominal pain and orthostatic hypertension, other symptoms associated with Nephroptosis include anxiety, unintentional weight loss, frequent infections involving the urinary tract, and palpitations. This article explains in detail some of the potential causes of Nephroptosis and the treatment options available for it.[2]
What Causes Nephroptosis?
Since the topic of Nephroptosis has not been researched much, the primary cause of this condition is not yet known. Based on the data on Nephroptosis that is available, some physicians opine that this condition may be caused due to the ligaments that hold the kidney in its anatomical space getting weak. Some of the causes that may lead to weakness of these ligaments include sudden unintentional weight loss, pregnancy and delivery, trauma to the abdominal region, and over-exercising. However, this theory is not substantiated by concrete evidence.[2]
There are however certain risk factors which increase the risk of an individual developing Nephroptosis. These factors include female gender. It is seen that Nephroptosis is seen more in females than males. Additionally, people with low body mass index also are at risk for developing Nephroptosis. People who have frequent urinary tract infections also are at risk for developing this condition.[2]
How is Nephroptosis Treated?
Coming to the treatment options, as stated, surgery was believed to be the primary treating option for Nephroptosis. The procedure was termed as nephropexy.
However, physicians of late are staying away from this procedure as it does not always resolve the symptoms completely.[2]
As of now, the physicians suggest starting with a noninvasive approach towards treating Nephroptosis. These measures include diet to increase weight and strengthening exercise to make the abdominal muscles strong. If this measure fails, then surgery is the preferred option. However, due to the rarity of the condition the outcome of surgical procedure is not well understood.[2]
Some studies have stated that laparoscopic renal fixation has had good outcomes in people with Nephroptosis pertaining to complete resolution of symptoms. This procedure is minimally invasive and just a small nick is needed to get access to the kidney and get it back to its normal position. This surgery has not been made a standard treatment as of yet as there are very less cases where this had to be performed.[2]
In conclusion, Nephroptosis is a rare disease in which the kidney moves out of its normal position when the patient changes position from supine to upright. This results in intense abdominal pain, orthostatic hypertension, and unintentional weight loss. Diagnosis can be made through radiographs in the supine and upright position. Not much research data is available when it comes to the causes and treatment options for Nephroptosis.[1, 2]
