Nephroptosis is a condition in which one or both kidneys drop around 5 centimeters below their correct position in the abdomen when a person stands up.
The kidneys are a set of bean-shaped organs responsible for filtering waste from the blood and producing urine in the body. They’re located in the abdomen on either side of the spine, just below the rib cage. Nephroptosis may also be called floating kidney, wandering kidney, or renal ptosis.
Most people with nephroptosis don’t experience any symptoms and don’t require any treatment. People with severe cases might need a surgery called laparoscopic nephropexy to fasten the kidney in its proper place. However, most cases of nephroptosis don’t require medical care.
Most people with nephroptosis have no symptoms at all. In some individuals, symptoms occur when standing and are often relieved when lying down. These symptoms include:
- a sharp side (flank) pain that radiates into the groin
- nausea
- vomiting
- high blood pressure
- an abdominal mass when standing upright
- a weighing feeling in the abdomen
- hematuria (blood in the urine)
- proteinuria (excessive protein in the urine)
- a history of repeated urinary tract infections (UTIs)
Roughly
Nephroptosis is a congenital condition, which means you are born with it. Like other organs, the kidneys are relatively mobile. They can shift a couple of centimeters without problems.
In nephroptosis, however, the kidney or kidneys descend more than 5 centimeters when someone moves from lying down to standing up. The exact reason for this is not well understood.
It’s believed that the movement of the kidney is related to insufficient support from certain structures or the connective tissue surrounding the kidneys.
Nephroptosis is more common in females, especially those in smaller bodies. It’s
Nephroptosis isn’t considered a harmful condition. Treatment is only recommended in people with symptoms.
In the past, weight gain, frequent lying down, abdominal corsets or bandages, and abdominal exercise were recommended to help treat symptoms. Unfortunately, these treatments have shown little success in managing symptoms. They are no longer recommended.
Nephroptosis is now treated with a surgical procedure known as laparoscopic nephropexy. It’s important to carefully consider the risks of having surgery. In this procedure, the floating kidney is secured in its correct position.
Laparoscopic nephropexy is a minimally invasive modern treatment. It’s done under general anesthesia. The procedure generally takes 45 minutes and requires a hospital stay of 2 to 4 days.
One 2007 study evaluated the short- and long-term effectiveness of laparoscopic nephropexy. Some people reported a significant decrease in pain, a decrease in UTIs, and an overall improvement in quality of life following the procedure. There were no major complications during the study.
In the past, nephropexy was a controversial procedure. It was often ineffective and carried a high risk of death. These issues may have been caused by incorrect diagnosis and because it was done as open surgery. The procedure was so ineffective that for some time it was nearly completely abandoned by urologists.
The modern version of the procedure is much safer because it’s done laparoscopically. This means the procedure is performed through small incisions with the aid of a camera. Advancements in diagnosis and surgical methodology have also made the surgery much more effective.
Some people with symptomatic nephroptosis may experience a syndrome called Dietl crisis. In Dietl crisis, the floating kidney obstructs the ureter, the narrow tube leading from the kidney to the bladder.
This can result in:
- violent flank pain
- nausea
- chills
- tachycardia (fast heart rate)
- low urine output
- hematuria (blood in the urine)
- proteinuria (excessive protein in the urine)
- an enlarged, tender kidney
Dietl crisis is usually resolved by lying down and bringing the knees up into the chest.
People with nephroptosis may also experience frequent UTIs. A UTI is an infection of the urethra, bladder, or kidneys, typically caused by bacteria. Symptoms of a UTI in the urethra or bladder include:
- burning with urination
- increased frequency of urination
- bloody or cloudy urine
When the kidneys are involved, UTIs can be life threatening. Symptoms of UTIs involving the kidneys include:
- pain and tenderness in the upper back and sides
- chills
- fever
- nausea
- vomiting
The majority of people with nephroptosis don’t have any symptoms and the condition is harmless. No treatment is recommended in these cases.
In people with symptoms, surgery is usually the only effective treatment to help relieve symptoms. In the past, surgery for nephroptosis had a high mortality rate. Modern surgical procedures are safe and effective. If you suspect that you have symptoms of nephroptosis, talk to your doctor.