Hydronephrosis caused swollen feet

My grandfather swollen feet for two months, the location is the following two legs of the belly bulge. Results of the inspections at the hospital with normal renal function, but the loss of the protein with the urine, so his body half of the protein is only normal. Now doctors proposed to do renal biopsy, I do not know whether it is necessary to do? What degree of physical damage?


My grandfather is currently in Urumqi Medical treatment, medical technology should be excellent.

Renal biopsy is clearly the type of renal disease as a pathological examination, it is a clear indication, your grandfather's condition has edema and severe hypoproteinemia, in the etiology and pathology do not understand the situation, not to take effective treatment, so doctors recommend is necessary, but also to judge the hospital you do not have the ability, if you believe his technical ability, you still listen to the doctor. renal biopsy indications master if a skilled, generally will not cause any serious complications, a common hematuria, perirenal hematoma, usually very light and does not cause aggravation of the primary renal disease and renal damage.

Renal biopsy it? Relatively safe, please rest assured.

Hydronephrosis
(A) of the generous state
Discharge of urine from the renal pelvis obstructed, resulting in increased intrarenal pressure, expansion of renal pelvis, renal parenchymal atrophy, known as hydronephrosis.
(B) Clinical manifestations
Adjacent to the urinary system and its various diseases caused by urinary obstruction, and ultimately can cause hydronephrosis. As a result of obstruction of the original disease, location and extent of the differences in the different clinical manifestations of patients with hydronephrosis and the process is not consistent. Congenital lesions, such as ureteropelvic junction stenosis, renal vascular or lower pole ectopic ureter and other fiber bundles caused by compression of hydronephrosis, the development is relatively slow, long-term no obvious symptoms, when a certain volume of abdominal mass. Ministries of urinary stones, cancer, inflammation and tuberculosis caused by hydronephrosis secondary to clinical manifestations were primary signs and symptoms, the disease rarely show hydronephrosis, as is often made in complete obstruction and and abrupt, such as renal and ureteral stones and renal colic when incarcerated before they were discovered. Hydronephrosis secondary to infection, the disease usually presents symptoms of the original increase.
Hydronephrosis was intermittent episodes sometimes called intermittent hydronephrosis. Severe attack of ipsilateral abdominal cramps, nausea, vomiting, decreased urine output; by several hours or longer, the pain disappeared, and then emit large amounts of urine. This situation prevalent in the ureteral obstruction.
Long hydronephrosis caused by obstruction, will eventually lead to renal function decline. Bilateral renal or complete obstruction of solitary kidney anuria can occur, resulting in renal failure.
Need to mention that during normal pregnancy are often mild kidney, hydroureter. In addition to pregnancy outside the uterus ureteral compression is due to the secretion of progesterone during pregnancy causes renal pelvis and ureter due to muscle relaxation. The hydronephrosis is a physiological state, because almost all of anatomy in the right place.
(B) Diagnosis
Should first determine the existence of hydronephrosis, and then identify the cause of hydronephrosis, lesion location, extent, with or without infection and renal damage. The differential diagnosis of abdominal masses should be noted that there is the possibility of hydronephrosis. Hydronephrosis can be inconsistent mass tension, such as the mass of the tension is low or when the soft-hard when there are fluctuations in a sense, the very possibility of hydronephrosis. Some secondary hydronephrosis, the primary disease, the symptoms are significant, such as tuberculosis, cancer and so easy to overlook the presence of hydronephrosis. Adjacent to the urinary system diseases and renal urinary obstruction caused by water, are often not diagnosed in time, and even to kidney failure or no urine was found until the time. Laboratory tests should include blood tests to see whether the azotemia, acidosis and electrolyte disturbances. Urine, in addition to routine examination and culture for the outside, if necessary, take the line of Mycobacterium tuberculosis and cytology examination.
Urography in the diagnosis of significant value. Excretory urography one of the typical performance of prolonged renal development. Reduce the glomerular filtration rate, tubular urine flow in slow and increased reabsorption of water that gathered in the renal cortex of contrast agents, mainly in the proximal convoluted tubule, leaving clearer renal imaging. Therefore, there strong impact of acute renal obstruction characteristics. Delayed high-dose excretory urography, more helpful in the diagnosis of hydronephrosis; contrast dose can increase 2 to 3 times, delay times of up to 24 to 36 hours. Excretory urography is not clear enough, it can by cystoscopy for ureteral catheterization, retrograde pyelography; catheterization after renal pelvis, hydronephrosis can be removed if a lot of urine, while determination of lateral renal function. Difficulties such as retrograde intubation, renal biopsy may be diverted to angiography. Puncture in the retrograde pyelography and angiography, should prevent the bacteria into the water in the kidney.
Ultrasound, CT, MRI examination can increase the renal clear distinction between the stagnant water, or solid mass was also found that urinary system diseases oppression, as ultrasound has spread and is non-invasive, can be carried out before urography. Radionuclide scan and renogram can be used for the diagnosis of hydronephrosis. Dynamic obstruction of cases is observed in urography pelvis, ureter motility and emptying. Neurogenic bladder can be seen cystography shape of "pagoda", successful trabecular and pseudo diverticulum.
(C) treatment
According to the etiology, pathogenesis Jihuan, with or without infection and renal damage, combined with patient age and cardiopulmonary function considered.
1. Etiological treatment best treatment is to remove the cause of hydronephrosis, keep suffering from kidney. If the obstruction has not yet caused serious irreversible lesions, after the removal of the cause, get good results. Surgical method depends on the nature of the cause, such as congenital ureteropelvic junction obstruction can be used for angioplasty of renal pelvis, kidney, ureter stone gravel or lithotomy possible, these operations carried out in recent years, the endoscope can be used. Hydronephrosis and renal function after surgery to improve.
2. Renal fistulization in critical condition, or if not remove the cause of hydronephrosis, should be more than in the first drainage obstruction, to be infection control, and then remove the cause of the purposes of surgery. Cause of obstruction can not be terminated, then as a permanent nephrostomy treatment.
3. Nephrectomy severe hydronephrosis, the remaining renal parenchyma is too small, or with severe infection of the kidney empyema, such as contralateral renal function, renal resectable disease.
(D) Nursing care for patients after hydronephrosis
1 Pc urinary leakage
Related factors: associated with surgery
Nursing measures: (1) washing with metronidazole for pelvic drainage tube 10ml twice a day;
(2) TDP irradiation the wound for 30 minutes once a day;
(3) note left kidney urine, wound drainage volume;
(4) dressings soaked inform your doctor promptly replaced.
(5) to maintain unobstructed drainage, drainage tube will be properly secured to prevent compressed, folded, and twisted.
2 infection
Related factors: surgical trauma together with the indwelling catheter related
Nursing measures: (1) prescribed use of antibiotics;
(2) 4 times per day measured temperature;
(3) Daily cleaning with 0.1% benzalkonium bromide urethra twice daily replacement of drainage bag;
(4) maintaining unobstructed drainage, strict implementation of aseptic technique;
(5) after flatus, to encourage patients to drink more water, more than 3000ml per day, and eating
Nutrient-rich diet.
3 pain
Related factors: trauma-related surgery
Nursing measures: (1) placebo patients, to ease tension;
(2) to guide patients and their families the proper use of analgesia pump to protect the painful area and alleviate the master
Way of pain;
(3) was prescribed for analgesic effects after treatment were observed and recorded;
(4) to adjust a comfortable position.
4, the risk of skin damage
Related factors: related with postoperative bed
Nursing measures: (1) to explain to patients and their families the importance of keeping the skin intact, to obtain their co-ordination and
Explain their methods of skin care and skin from the risk factors;
(2) to help patients change position regularly in sequence, and the bony protrusion at the massage;
(3) clothes, mattresses maintain the soft, flat, dry, clean with no residue;
(4) to guide the patient bed activities skills development program of activities in bed.
5 Constipation
Related factors: the bed on
Nursing measures: (1) to encourage patients to strengthen the bed activities;
(2) eat more vegetables and fruits with high fiber foods, drinking water;
(3) the patient is difficult to discharge, to give physical defecation;
(4) guide the patient to develop good bowel habits.

Hypoproteinemia, is the kidney puncture. But still clear the check liver function.