|Symptoms||asymptomatic in most; may have violent attacks of colicky flank pain, nausea, chills, hypertension, hematuria and proteinuria|
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 in terms of both its diagnosis and its treatments.
Nephroptosis is asymptomatic in most persons. However, nephroptosis can be characterized by violent attacks of colicky flank pain, nausea, chills, hypertension, hematuria and proteinuria. Persons with symptomatic nephroptosis often complain of sharp pains that radiate into the groin. Many persons also suggest a weighing feeling on the abdomen. Pain is typically relieved by lying down. It is believed that flank pain on standing that is relieved by lying down is due to movement of the kidney causing intermittent renal tract obstruction. The attack of colic pain is called 'Dietl's crisis' or 'renal paroxysm'.
It is believed to result from deficiency of supporting inferior pararenal fasciae.
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.
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.
- 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.
- 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.