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Renal ptosis is a rare condition in which one of the kidneys is not properly secured into place in the abdomen. It assumes its normal position when lying down, but drops downward when standing. Most cases of renal ptosis are asymptomatic; people never experience health problems or discomfort. In some cases, however, the motion of the kidney can lead to significant pain, vomiting, chills, and other symptoms. A surgical procedure called nephropexy can be performed in a symptomatic case to permanently affix the kidney to the abdominal wall.
The causes of this condition are unknown, but doctors have identified a few notable risk factors for developing the condition. Renal ptosis is more likely to affect women than men, and it is most frequent among very thin, young adults. People who lose significant amounts of weight very quickly are at an increased risk as well. Many doctors believe that the problem is related to a lack of supportive muscle and fat tissue in the lower abdomen.
The degree of kidney displacement in the disorder is relatively small, usually no more than 2 inches (about 5 centimeters). When a person stands, the kidney descends and puts strain on the ureter leading to the bladder. The motion is usually subtle enough that symptoms are not apparent, although renal ptosis can cause sharp pains in the side, nausea, vomiting, and chills. Acute symptoms tend to get better after lying down for a few minutes. If the ureter becomes irritated or obstructed by kidney movement, a person may have blood in the urine or develop frequent urinary tract infections.
A doctor can diagnose renal ptosis by reviewing the patient's symptoms, screening for other possible problems, and taking x-rays of the abdomen. X-rays that are taken while the patient is lying down are compared to images taken while standing to see if there is noticeable kidney displacement. Treatment decisions are made based on the severity of symptoms.
In many cases, a person can avoid surgery by taking pain relievers, limiting his or her physical activity, taking frequent breaks during the day to lie down, and gaining weight. If problems persist, however, the patient may need to undergo nephropexy. A surgeon makes a small incision in the lower abdomen and inserts an endoscope to guide the procedure. He or she uses specialized staples or sutures to attach the kidney to a band of strong, fibrous tissue in the abdomen. Nephropexy has a high success rate, and most patients do not experience recurring problems.
My sister is a very thin young lady. She eats plenty of food, but she just never seems to gain weight. That probably put her at risk of getting renal ptosis.
She started getting urinary tract infections every few months. She drank lots of water and cranberry juice and ate a healthy diet, so she did not know what could be causing them.
During her last infection, she got really sick and started throwing up. She complained that her side hurt.
Her doctor decided to do some x-rays to test for kidney displacement. He had her sit for some and stand for others, and he saw that there was a two-inch difference in the placement of her kidneys between the two positions.
Her high metabolism meant that she probably would have trouble packing on enough pounds to support her kidneys, so she underwent nephropexy. That fixed all her symptoms.
My friend lost a lot of weight after her boyfriend died in a car wreck. She did not eat for days afterward, and even when she eventually tried to eat, she could not keep anything down.
Finally, she took to drinking smoothies and eating soup. Those were the only things she could keep in her system. She lost 30 pounds and became dangerously skinny.
She started having stabbing side pains. They were absolutely debilitating. She started to feel ill and shake all over, as though she were cold.
Her doctor discovered that she had renal ptosis. Since he knew from her situation that it would take a long time for her to recover mentally enough to put
weight on, he decided surgery was the best option.
After her surgery, he suggested grief therapy. She gave it a shot, and though she will never fully get over what happened, she is improving, and she is slowly starting to eat solid foods again.
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