Kidney dystopia: symptoms, causes, diagnosis and treatment

Kidney dystopia is a congenital pathology, which consists in the incorrect location of the organ. Depending on its location, several types of dystopia are distinguished. The frequency of diagnosis of this pathology among newborns is 0.1%.

In most cases, unilateral dystopia is diagnosed when only one kidney has an incorrect localization in the body.

This pathology can be accompanied by acute pain and disturbances in the digestive and urinary systems. Patients with renal dystopia are at higher risk of developing urolithiasis, hydronephrosis, pyelonephritis and other diseases.

general information

Dystopia is any abnormal structure of an organ; the term refers to a paired organ. Initially, the kidneys are formed in the pelvic region; as other structures in the fetal body develop, they “rise” to their usual place (the process is completed by the middle of the second trimester of pregnancy).

Dystopia is the result of a congenital malfunction in development; with nephroptosis, deviations occur after the complete formation of the kidney and its bed. Based on the facts described above, we can conclude that the anomaly is formed against the background of parental genome deviations or a serious pathological process during intrauterine development.

Forecast

If dystopia is detected, a person should definitely visit a urologist. The prognosis is influenced by the development of complications. Pelvic dystopia of the right or left kidney is not a contraindication for pregnancy. However, without medical control of the disease, complications may develop leading to fetal death.

By regularly visiting a urologist, it is easier to prevent serious consequences of kidney displacement. Dystopia is allowed to be treated with traditional medicine, but only with the consent of the doctor.

Reasons for the development of the anomaly

The appearance of renal anomalies is influenced by many negative factors:

• consumption of alcoholic beverages, tobacco, and drugs during pregnancy;
• severe stress or psychological trauma during childbearing;
• hereditary factor;
• exposure of the fetus to a variety of toxic substances, including pesticides and dyes consumed with food.

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Prevention

If a person is diagnosed with dystopia, it is important to prevent the development of pathologies that can complicate abnormal development. To do this you need to follow a diet. It is recommended to include in the menu:

• vegetables;
• cereal dishes;
• low-fat food;
• fruits;
• small amount of salt.

Antihypertensive drugs can be taken to lower blood pressure. Antibacterial drugs will help stop the growth of bacteria. Pregnant women with congenital renal dystopia should avoid exposure to adverse factors and follow all recommendations of the attending physician. Patients are required to regularly visit a urologist - he will help prevent possible complications.

Classification

Doctors know cases of unilateral and bilateral abnormal structure of a paired organ. If one organ is located on the opposite side, doctors diagnose cross dystopia. When the kidney is located in its half of the body, but incorrectly, the patient has a homolateral type of pathology.

Depending on the location of the paired organ, several forms of anomaly are distinguished:

• lumbar The paired organ is located lower than it should be. With such dystopia, the renal pelvis faces forward. During palpation, the organ is felt in the hypochondrium;
• pelvic. The paired organ is located between the bladder and rectum (in the stronger sex)/uterus (in women). This dystopia is characterized by shortening of the ureter; upon examination, it looks like an ectopic pregnancy or a cyst in the ovaries;
• ileum. The kidney is located in the iliac fossa and is often mistaken for a cystic formation in the ovary;
• subdiaphragmatic. The paired organ will blend upward, up to the chest. All vessels and the ureter are elongated. Most anomalies are mistaken for a tumor or cyst on the lung, an abscess, or encysted pleurisy.

Depending on the type of dystopia, the symptoms may differ; some anomalies are asymptomatic, others can cause serious health problems.

Interesting to know! According to statistics, right-sided dystopia in the lumbar region is often found. The anomaly is characterized by prolapse of the right kidney several centimeters below its intended location. During the initial examination, such pathology is often confused with tumor formations. Dystopia of the right kidney is observed in 58% of all cases, of the left - 33%, of both - 9%.

Possible complications

Unforeseen consequences of kidney dystopia are faced mainly by people who prefer traditional methods of treatment. It is not always possible to detect organ displacement even with the help of modern ultrasound machines. Traditional healers do not have modern diagnostic equipment and sufficient knowledge, so instead of inflammation of an incorrectly located organ, they begin to treat another, self-made diagnosis. As a result, the patient's condition worsens, since the main cause of poor health continues to progress.

In many cases, after surgery, the patient is given a catheter to artificially remove urine from the body. A person who finds himself in such a situation often experiences difficulties with social adaptation. In this situation, it is advisable to seek help from a psychotherapist, especially if the problem affects a teenager or child

Another complication of the pathology is the mechanical effect of the displaced organ on others. For example, if a woman has pelvic dystopia of the right kidney, pressure may be placed on the uterus. Venous vessels, nerve nodes and large arteries may be influenced by an organ that is not in its proper place. Such cases are considered the most dangerous. With such exposure, neurological symptoms may occur, for example, deterioration of sensitivity in certain areas of the body, as well as their trophic changes (poor skin condition, hair loss, etc.).

Characteristic signs and symptoms

The clinical picture of the pathological condition depends on the degree and nature of dystopia of the paired organ:

• lumbar (is the most favorable type of disease). The anomaly is often asymptomatic or causes discomfort in the lumbar region of an unexpressed nature;
• Ileal dystopia is characterized by pain in the abdominal region; the fair sex feels the situation worsening during menstruation. Discomfort is formed against the background of compression of neighboring organs, squeezing of nerve endings. The anomaly causes the bladder to become misaligned, leading to problems with urination. A negative effect on the intestines contributes to constipation, bloating, stomach cramps, and it can even lead to attacks of nausea and vomiting;
• pelvic dystopia negatively affects the intestines and the functioning of the female genital organs. The anomaly is accompanied by constipation, frequent urge to go to the toilet, and discomfort that accompanies the act of urination. Pelvic anomaly of the kidney structure negatively affects pregnancy and contributes to prolonged toxicosis. Such a patient should be constantly under medical supervision before and after pregnancy;
• pathology of the right kidney in the chest area is accompanied by unpleasant sensations while eating;
• cross dystopia often leads to dysfunction of the paired organ; in the case of compression of blood vessels, the patient is constantly accompanied by increased renal pressure (even at a young age).

Clinical picture

Symptoms of the pathology are largely determined by the anatomical location of the displaced organ.

For example, lumbar dystopia of the kidney often does not have pronounced clinical manifestations. Periodically, muted pain may occur in the affected area. Patients with an ileal appearance anomaly account for about 12% of all cases. They usually complain of discomfort in the abdominal wall. Pain syndrome is associated with pressure from nearby organs. Other manifestations of the disease include urinary disorders, constipation, stomach cramps and flatulence. In women, its exacerbation is observed during menstruation.

Pelvic dystopia of the kidney is characterized by severe pain in the intestinal area and regular constipation. If the displaced organ puts pressure on the bladder, the patient is bothered by the desire to constantly empty it. This form of pathology is rare, but is considered dangerous for women of childbearing age. It can negatively affect the course of pregnancy, provoke complications and increased manifestations of toxicosis.

Subphrenic dystopia is difficult to diagnose. It manifests itself as painful sensations behind the sternum, which may be accompanied by shortness of breath and problems with the functioning of the digestive tract.

Diagnostics

Pathology can be detected in several ways:

• examination of the patient. For men, a rectal examination can be used, for women, a vaginal examination. Thus, a sedentary formation is detected, which is located between the intestines and the bladder/uterus;
• X-ray of the pelvis and chest may indicate an abnormal structure of the kidneys;
• use of ultrasound. During this examination, a flattened, round or oblong shape of the kidney may be detected. The pelvis may be absent altogether or have the same vertical and horizontal dimensions. Also, during ultrasound, abnormalities of the ureter and blood vessels are clearly visible;
• Kidney MRI. This analysis makes it possible to clarify the specific location of the diseased kidney and its interaction with other organs;
• Laboratory tests allow you to assess the functioning and condition of the excretory system and kidneys.

Diagnostic manipulations make it possible to differentiate the abnormal location of the kidney from other pathologies (prolapse of a paired organ, formations of a different nature), and to identify existing concomitant diseases.

How to detect the presence of pathology

A kidney that has been affected by dystonia is slightly flattened in the front part, and also has a pear-shaped or even oval shape, although a normal kidney is bean-shaped. The dimensions of the affected organ are much smaller than those established by the norm, the cups are turned towards the spine, and the pelvis is located on the surface. The movement of the affected kidney is limited due to the location of the vessels being too low.

It is important!

In lumbar dystonia, the kidney is located in the lumbar region, but below its usual location. In this case, the renal artery leaves the aorta too low, and the renal pelvis is directed forward. The patient may often complain of pain in the lower back.

When diagnosing this anomaly in the structure of the organ, doctors can detect a tumor in the area under the ribs. Sometimes, during an ultrasound examination, such a sign becomes the reason for an incorrect diagnosis, for example, nephroptosis. But the main distinguishing feature of dystonia from nephroptosis is the immobility of the organ and the ureter being too short.

It is best to diagnose renal dystonia using X-rays, or more precisely, using voiding cystography - an X-ray examination of the kidneys and organs of the urinary system during urination. Retrograde ureteropyelography is also often organized - an examination in which catheterization of the ureters is carried out using a contrast agent.

Effective treatments

Therapy directly depends on the functioning of the displaced kidney, the negative impact on neighboring organs; the location and extent of the damage are not so important when choosing treatment.

Conservative therapy includes several aspects:

• When inflammatory processes occur, the patient is prescribed antibiotic therapy. The choice of medication is based on the specific type of pathogenic microorganism that caused the pathology;
• Painkillers (Baralgin, Spazmalgon, Spazgan) will help alleviate the patient’s condition and relieve pain.

The combination of these drugs has an anti-inflammatory effect not only on the diseased kidney, but also on nearby organs and systems. Conservative therapy includes preventive measures aimed at preventing the occurrence of urolithiasis and other diseases of the kidneys and excretory system.

When complicated by pyelonephritis, antibiotics of other groups are used, and the patient is prescribed drugs that stimulate blood flow. In some situations, conservative therapy requires surgical removal of kidney stones.

Surgery

Surgical intervention is indicated for circulatory problems in a displaced kidney and negative effects on nearby organs. The principle of the operation is to remove the diseased kidney or move it to its normal position. Nephrectomy is indicated for necrosis of renal tissue. Before the operation, you need to make sure that the second kidney is working.

If there are no complications, the patient is registered with a urologist. The prognosis is determined by the course of the pathological process, the appearance of concomitant diseases (hydronephrosis, pyelonephritis).

The need for surgery

Surgical treatment is justified only in case of circulatory problems in the displaced organ. It comes down to removing the kidney or moving it and securing it in the correct place from an anatomical point of view. Total resection is resorted to when there is complete necrosis of the renal tissue. In this case, before surgery, doctors carefully examine the paired organ and evaluate its functionality.

Kidney dystopia in a child

Often, an anomaly in the location of a paired organ is not noticed until an ultrasound or x-ray is performed for another reason. In some cases, pathology is noticed during fetal development. Only the physician decides what to do next after diagnosing dystopia. In most cases, the anomaly does not in any way interfere with the child’s normal development, and no therapeutic measures are necessary. If the life of a small patient is threatened, the doctor prescribes a course of therapy, sometimes a surgical solution to the problem.

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How is it diagnosed?

This pathology is detected by physical, laboratory and instrumental methods. A nephrologist makes a diagnosis based on complaints, anamnesis, symptoms, palpation data, results of blood and urine tests, ultrasound data, urography, angiography, radioisotope method and MRI.

If extensive renal damage is present, nephrectomy is indicated. Division of the Kidney, School of Medicine, Emory University School of Medicine, Atlanta, GA. Ultrasound is commonly used in nephrology for diagnostic studies of the kidneys and lower urinary tract and for percutaneous procedures such as the insertion of hemodialysis catheters and renal biopsies. Therefore, nephrologists must have a thorough understanding of renal anatomy and the sonographic appearance of the normal kidney and lower urinary tract, and must be able to recognize common abnormalities.

Iliac and lumbar dystopia are determined by palpation of the frontal abdominal wall; pelvic dystopia is diagnosed by manual examination. To clarify, contrast urography is required.

Thoracic dystopia is detected on a chest x-ray in the posterior mediastinum as a dense rounded shadow above the level of the diaphragm.

Does the pathology have symptoms?

Correct interpretation requires correlation with the clinical scenario.
With the advent of affordable portable scanners, sonography has become a procedure that can be performed by nephrologists and is both trained and certified in renal ultrasonography. Sonography is an important tool in nephrology, not only for the diagnosis and treatment of kidney diseases, but also for guiding invasive procedures. For this reason, it is critical that nephrologists have a thorough understanding of sonography and its use in nephrology. Visualizing instrumental methods help differentiate dystopia from nephroptosis and tumors.

Useful tips

Dystopia is considered a congenital pathology, so prevention should be carried out even before the baby is born. Before planning a pregnancy, undergo genetic counseling to exclude the possibility of an anomaly in future offspring.

During the period of bearing a child, follow several useful recommendations:

• stop drinking alcohol, nicotine, and drugs;
• Beware of radioactive and chemical exposure;
• do gymnastic exercises, stick to proper nutrition.

Dystopia is an abnormal location of the kidney; the pathology may not pose a threat to the health and life of the patient, but constant monitoring of the patient’s condition is recommended. If complications occur, immediately consult a doctor and get treatment.

Video. A specialist from the Moscow Doctor clinic talks about pathologies of the development of paired organs, including kidney dystopia:

Therapy

Usually the pathology is discovered during the next preventive examination or when the patient complains of deterioration in health, pain in the lumbar region. After palpation and questioning, an ultrasound, MRI or radiography is performed. With the help of these studies, the presence of neoplasms can be confirmed or refuted. A comprehensive examination also includes:

1. General blood and urine tests - with dystopia, there will definitely be deviations from normal values.
2. Ultrasound examination - determines the location of the kidneys and their condition. It also eliminates nephroptosis.
3. If necessary, excretory urography is performed - it helps to identify abnormal placement of the organ or disturbances in its functioning.

General blood and urine tests, which, in case of dysfunction of a dystopic kidney, will show deviations from the norm

When dystopia is accompanied by infection or inflammation, conservative treatment is indicated. If we are talking about pyelonephritis, the patient is prescribed broad-spectrum antibiotics. If dystopia causes pain, the patient may be prescribed analgesics or non-steroidal drugs.

In case of urolithiasis, stone removal is required. Many patients are recommended drugs whose action is aimed at improving blood circulation in the kidneys. For complications such as hydronephrosis, increased pressure on nearby organs and kidney injury, surgical intervention is performed. Removal is possible only if the organ has completely died, if the presence of a second kidney is confirmed by examination results.

Unconventional methods of therapy

Dystopia cannot be cured with conservative methods. Patients are prescribed symptomatic therapy, which is designed to eliminate concomitant ailments - urolithiasis, infectious processes. For this purpose, anti-inflammatory, antimicrobial and cleansing agents are used. Regular prevention of possible kidney diseases and cleansing of the body is also required.

Alternative medicine is ideal for treating the disease. As a rule, these are medicinal herbs and natural products that do not have a toxic effect on the human body. There are several popular recipes:

• Yarrow, St. John's wort and chamomile - brew the plants and leave for fifteen minutes, then filter. Drink up to three times a day. The treatment is carried out for a week for each herb. The course is repeated twice a year.
• Plantain and nettle leaves, rose hips, red currant fruits are an excellent preventive measure for urolithiasis. Herbs can be consumed individually or made into infusions.
• Strawberries and wheatgrass are used to cleanse the body. Pour boiling water over ten leaves with stems of berries or crushed wheatgrass roots, leave for fifteen minutes, strain and drink.

Alternative medicine is ideal for treating the disease.

Useful tips

An integral component of therapy is lifestyle. The patient must eliminate all bad habits, reconsider their usual lifestyle, and avoid hypothermia. It is important to prevent bacterial infections from entering and treat them promptly. The chronic infectious process of pyelonephritis becomes a potential culprit of infection.

To prevent and treat kidney dystopia, it is recommended to review your usual diet. It must be correct and consist of home-cooked dishes. It is extremely important to reduce the amount of animal protein. The priority is vegetarian food, an abundance of vegetables and fruits. To cleanse the kidneys, it is advisable to include watermelon, celery, parsley, and asparagus in the menu. It is recommended to cook the dishes and eat them in crushed form. The best eating regimen is five times a day.

Hydronephrosis

Hydronephrosis is a fairly common kidney disease, characterized by chronic obstruction of urine outflow and dilation of the pelvis.
In the initial stage of the disease, the accumulation of fluid in the pelvis does not have a significant effect on the kidney parenchyma, and therefore they only talk about pyelectasia. Subsequently, the kidney tissue atrophies. In some cases, atrophic changes occur quickly, in others they develop slowly. The right and left kidneys are affected equally often; in a small percentage of cases (5-9%), hydronephrosis is bilateral. The folk way to cleanse the kidneys! Our grandmothers were treated using this recipe...

Cleaning your kidneys is easy! You need to add it during meals...

In many patients, hydronephrosis occurs at a young age, although the largest number of patients seek help at the age of 20-40 years. However, if we take into account the possibility of asymptomatic hydronephrosis, it can be assumed that the appearance of the first symptoms does not always correspond to the onset of the disease.

There are congenital and acquired forms of hydronephrosis. Congenital hydronephrosis occurs in the prenatal period as a consequence of abnormal development of the kidney and urinary tract. In some cases, the cause of congenital hydronephrosis is a mechanical obstruction to the outflow of urine, in others it is insufficiency of the muscles of the upper urinary tract. Acquired hydronephrosis occurs during the patient’s lifetime due to various reasons that impede the outflow of urine from the pelvis and disrupt the dynamics of the urinary tract. Ureteral strictures, one of the common causes of hydronephrosis, are in most cases congenital, but can also be of inflammatory and traumatic origin. Quite often, in addition to the narrowing of the ureter, it is also found to be obliquely extending from the pelvis, as a result of which it, like a valve, covers the exit of urine from the pelvis. Inflammatory adhesions that compress the ureter can also cause hydronephrosis. They arise as a result of infection in the tissues and organs near the ureters (for example, in the genitals of a woman).

Similarly, trauma to the lumbar region may be accompanied by damage to the ureter with subsequent formation of a stricture and, therefore, lead to hydronephrosis. Finally, under certain conditions, the accessory renal vessel, a congenital malformation, can cause hydronephrosis. This is usually the size of a matchstick or a goose feather, a vessel that goes to the lower pole of the kidney and crosses the ureter in the upper section.

Since with kidney dystopia there is often a disruption of the normal relationship between the pelvis and the ureter and there are additional vessels, hydronephrosis often occurs with this anomaly.

Among other causes of hydronephrosis, mention should be made of various mechanical obstacles, for example, kidney and ureteral stones, compression of the ureter by a retroperitoneal tumor or prostate tumor, prostatic hypertrophy, urethral structures, etc.

Consequently, the cause of the development of hydronephrosis is a constant disruption of the outflow of urine from the pelvis. Secondary atrophic changes in the kidney parenchyma during hydronephrosis occur under the influence of two factors - increased intrapelvic pressure and circulatory disorders.

Ileal dystopia

Ileal dystopia of both kidneys is not uncommon. The multiple renal arteries are supplied by the common large iliac artery.

Symptoms of the condition are abdominal pain, equally pronounced on the right and left sides. Displaced paired organs put pressure on surrounding tissues, and the nerve plexuses react to this. The pain is inconsistent and in women it often coincides with the menstrual cycle. An additional symptom is a violation of urodynamics.

The condition causes:

• gastrointestinal disease;
• causes nausea;
• vomiting;
• frequent signs of enterocolitis.

The deterioration of health cannot be explained only by rotation - general malaise appears during inflammatory processes in the most altered organ:

1. with urolithiasis;
2. hydronephrosis;
3. introduction of pathogenic microflora.

The position of the kidneys in the absence of ultrasound examination often led to serious errors.

Mistaking it for a neoplasm, it was removed surgically, mistaking it for a cyst or even a cancerous tumor of gynecological organs - the ovary or fallopian tube.

What it is?

According to the international classification, kidney dystopia refers to congenital anomalies, occurring in up to 2.8% of the total number of all defects, that is, in 1 out of 900 newborn children. The main reason for the malposition of the kidney is considered to be the stopping of its migration and rotation during the intrauterine formation of the embryo. Normally, the paired organ is localized at the XI-XII and I-III thoracic and lumbar vertebrae, respectively, and on both sides of the spine. Any other position is considered a deviation. A feature of the pathology is immobile fixation of the organ.

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Causes of kidney malposition

In a fetus developing in utero, the future kidneys, which are initially structurally a metanephros, are located in the pelvic area. In a fetus developing in utero, the future kidneys, which are initially structurally a metanephros, are located in the pelvis. In the second half of the developmental period in the unborn child, the excretory organs undergo a stage of rotation (turning) and rise higher relative to the spinal column, occupying a normal anatomical position at the lumbar level (lower thoracic vertebrae and upper lumbar). If the fetus is exposed to unfavorable factors during the period of migration and rotation of the paired organ, this process may be disrupted, as a result of which one of the kidneys, or less often both, is located atypically in the born child. With dystopia, the organ is fixed and cannot move more than the physiological norm. This is the difference between a congenital anomaly of location and nephroptosis, when the kidney is positioned incorrectly due to increased mobility, which is an acquired condition. In a fetus developing in utero, the future kidneys, which are initially structurally a metanephros, are located in the pelvic area. In a fetus developing in utero, the future kidneys, which are initially structurally a metanephros, are located in the pelvis. In the second half of the developmental period in the unborn child, the excretory organs undergo a stage of rotation (turning) and rise higher relative to the spinal column, occupying a normal anatomical position at the lumbar level (lower thoracic vertebrae and upper lumbar). If the fetus is exposed to unfavorable factors during the period of migration and rotation of the paired organ, this process may be disrupted, as a result of which one of the kidneys, or less often both, is located atypically in the born child. With dystopia, the organ is fixed and cannot move more than the physiological norm. This is the difference between a congenital anomaly of location and nephroptosis, when the kidney is positioned incorrectly due to increased mobility, which is an acquired condition.

Renal dystopia is characterized not only by the atypical location of the organ itself, but also by an abnormal blood supply system. The renal artery, when the kidneys are located low, does not arise from the aorta, but from smaller iliac vessels. In this case, the arteries are often bifurcated or multiple.

Important! The considered anomalies in the anatomical location of the kidneys do not necessarily lead to the formation of renal pathologies, but significantly increase the risk of their occurrence.

Symptoms of the disorder

An ectopic kidney gives different symptoms, which depend on the location and impact on neighboring organs. The main symptom is pain of varying intensity. Lumbar dystonia of the kidney may not cause pain, but mild discomfort in the lumbar region is possible. With the cross form, chronic kidney dysfunction develops, and with narrowing of the renal vessels, a persistent increase in blood pressure of a nephrogenic nature occurs already at a young age.

Depending on the location of the pain, different forms of the disease appear.

Ileal ectopia manifests itself:

• abdominal pain that worsens during menstruation in women;
• difficulty draining urine;
• flatulence, bloating, constipation;
• nausea, cramping pain in the stomach, vomiting.

With the pelvic variant of localization of both or one kidney, the following develops:

• pain in the rectum;
• painful menstruation, irregular menstruation, pain in the appendage area (in women);
• toxicosis, early delivery (in pregnant women);
• symptoms of acute pathology in the abdominal cavity.

Symptoms of intrathoracic localization of a paired organ:

• chest pain, worse after eating;
• feeling of a lump in the throat;
• signs of a diaphragmatic hernia (belching, heartburn, bloating).

Dystopic kidneys are susceptible to various kidney diseases of an inflammatory and infectious nature, which is manifested by corresponding symptoms. Characteristic symptoms of pathology in the kidneys are difficulty in draining or stagnation of urine. The danger of ectopia lies in the high risk of damage to the paired organ during surgery for another reason, performed in the peritoneum.

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Lifestyle and nutrition

Pelvic dystopia of the right kidney or any other form of pathology, even after completing the therapeutic course, requires adherence to a special diet.

Alcohol, fried, smoked foods, as well as various extracts are contraindicated for the patient. In general, the patient is recommended to adhere to table No. 7 not only immediately after treatment, but throughout the rest of his life.

A person’s drinking regime also plays an important role. It is better to give preference to ordinary purified water; do not get carried away with mineral water, since the components it contains can provoke the formation of kidney stones.

More than 85% of all medications taken for diseases of the paired organ can provide only a temporary effect, and they are harmful to the gallbladder and liver. This means that therapy and the patient’s further lifestyle should be aimed at maintaining not only the condition of the kidneys, but also all organ systems as a whole.

The fact is that the inflammatory process in the palatine tonsils starts at the mercy of hemolytic streptococcus, which places an additional burden on the paired organ.

In addition, the patient should monitor his own condition and avoid hypothermia.

After completing the therapeutic course, the patient is recommended to visit a resort with healing mud and radon baths. Physiotherapy is often added to these procedures.

Methods of examining patients

Treatment of patients should begin after a comprehensive examination. To identify a dystopic kidney, the following studies are required:

• Ultrasound;
• excretory urography;
• X-ray of the chest organs;
• angiography;
• scintigraphy;
• general blood and urine tests;
• pyelography;
• CT scan.

A survey and physical examination are required. Pelvic dystopia of the left kidney can be detected during a rectal or gynecological examination. Excretory urography is of great value. This method is based on the kidneys removing the dye by filtering the blood.

Contrast is administered intravenously. The thoracic form of dystopia on the left or right can be detected during fluorography. Angiography is performed to assess the condition of blood vessels. Blood pressure must be measured. To exclude heart disease, echocardiography and ECG are performed. Anamnesis must be collected. It helps to identify possible risk factors for the development of dystopia.

The following information is revealed:

• complaints at the time of examination;
• how long ago the first symptoms appeared;
• the course of pregnancy;
• hereditary history;
• the course of childbirth;
• presence of bad habits.

At the initial appointment with the doctor, a physical examination (palpation) is performed. Ileal dystopia in its course resembles kidney prolapse, tumors and intestinal diseases. Nephroptosis must be excluded. It differs from dystopia in that the displaced kidney is in an unfixed state. Otherwise it is called wandering.