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.
