Nephroptosis

For other uses, see Ptosis.

Nephroptosis
Classification and external resources
Specialty	urology
ICD-10	N28.8
ICD-9-CM	593.0

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]

Cause

It is believed to result from deficiency of supporting perirenal fasciae.

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 'Dittel's crisis' or 'renal paroxysm'.

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

↑ Moss SW (1997). "Floating kidneys: a century of nephroptosis and nephropexy". J. Urol. 158 (3 Pt 1): 699–702. doi:10.1016/S0022-5347(01)64296-4. PMID 9258063.

External links

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.
"Nephroptosis". Medcyclopaedia. GE. Archived from the original on 2012-02-05.

Diseases of the urinary system (N00–N39, 580–599)

Kidney disease

Glomerules

Primarily
nephrotic

Non-proliferative	Minimal change Focal segmental Membranous

Proliferative	Mesangial proliferative Endocapillary proliferative Membranoproliferative/mesangiocapillary

By condition	Diabetic Amyloidosis

Primarily
nephritic,
RPG

Type I RPG/Type II hypersensitivity	Goodpasture's syndrome

Type II RPG/Type III hypersensitivity	Post-streptococcal Lupus DPGN IgA/Berger's

Type III RPG/Pauci-immune	Granulomatosis with polyangiitis Microscopic polyangiitis Churg–Strauss syndrome

General

Tubules

Interstitium

Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy

General

General syndromes	Nephritis Nephrosis) Renal failure Acute renal failure Chronic kidney disease Uremic pericarditis Uremia Diabetes insipidus Nephrogenic Renal papilla Renal papillary necrosis Major calyx/pelvis Hydronephrosis Pyonephrosis Reflux nephropathy

Vascular	Renal artery stenosis Renal ischemia Hypertensive nephropathy Renovascular hypertension Renal cortical necrosis

Other	Analgesic nephropathy Renal osteodystrophy Nephroptosis Abderhalden–Kaufmann–Lignac syndrome

Urinary tract

Ureter	Ureteritis Ureterocele Megaureter

Bladder	Cystitis Interstitial cystitis Hunner's ulcer Trigonitis Hemorrhagic cystitis Neurogenic bladder dysfunction Bladder sphincter dyssynergia Vesicointestinal fistula Vesicoureteral reflux

Urethra	Urethritis Non-gonococcal urethritis Urethral syndrome Urethral stricture/Meatal stenosis Urethral caruncle

Any/all	Obstructive uropathy Urinary tract infection Retroperitoneal fibrosis Urolithiasis Bladder stone Kidney stone Renal colic Malakoplakia Urinary incontinence Stress Urge Overflow

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