World Kidney Day

Patient question: I have baggy kidney (hydronephrosis) and elevated liver enzymes. What does this mean?

“Baggy kidney” – or hydronephrosis – is a condition where urine builds up inside one or both kidneys causing them to become stretched and swollen.

Causes of hydronephrosis

The most common cause of hydronephrosis is a blockage somewhere in your urinary tract, or something disrupting the normal workings of your bladder. This causes urine to flow back from the bladder and into the kidney.

The main causes of the condition are:

• A renal stone, also known as a kidney stone, that has become trapped
• It can be congenital meaning you are born with it
• Urine retention, where the bladder is not emptying properly, causing it to overfill of urine
• Damage to the ureters (the tubes that run from the kidney to the bladder)
• Nerve damage in the bladder
• Cancers in the urinary tract area, such as prostate, bladder or cervical
• In men, a benign swelling of the prostate gland
• In women, pregnancy or a prolapse of organs in the pelvis.

Hydronephrosis treatment

For most cases, surgery is required to drain urine away from the kidneys and remove any blockage.

This is usually done using a catheter: a thin tube is inserted into your bladder through the urinary tract, or directly into the kidney through a small incision.

In very severe cases, a kidney may need to be removed.

The underlying cause will then need to be treated. For example, kidney stones can be operated on or broken up so they can be passed, and stents can be used to open damaged ureters.

The outlook for hydronephrosis is generally good as long as the condition is diagnosed and treated promptly. If left untreated for several weeks, the kidney may become scarred, and this can have an effect on the normal kidney function.

Elevated liver enzymes

When the liver is damaged, it releases enzymes into the blood. By assessing the levels of the relevant enzyme, you can see how much damage there is.

The causes of high liver enzymes can include:

• Alcohol - elevated liver enzymes are not always related to alcohol intake but they can be. Occasional alcohol intake does not normally cause any issue.
• Medications - some can elevate liver enzymes.
• A fatty liver - your doctor might mention you have a fatty liver or fatty infiltration of your liver on your scan results. A range of conditions can be caused by a build-up of fat in the liver. You tend to be more at risk of this if you are obese, especially if you carry a lot of weight around your middle.

Slightly elevated liver enzymes are usually of little concern and return to normal in a short period of time. But they do need to be monitored, usually by re-checking enzyme levels within a few months, to ensure there is not a trend of the enzyme levels rising, as this could indicate a potential problem.