Renal rotation abnormality

　　First, Etiology

　　It is generally believed that renal rotation abnormality occurs during the process of renal migration. In the 6th week, the kidney moves out of the pelvis, and the kidney begins to rotate, up to about 90° by the 9th week. Some people believe that renal rotation abnormality is due to asymmetric branching of the ureteral tree, with one towards the lateral side and the other towards the backside. Weyranch et al. also believe that the rotation of the kidney towards the lateral side is faster than that towards the backside in tissue differentiation, thereby causing a rotational error in this process.

　　Second, Pathogenesis

　　Weymuch divides the rotational abnormalities into 4 types according to the position of the renal pelvis:

　　1, Ventral position:Since the kidney did not rotate when it rose, the renal pelvis still points to the lateral side, and the renal pelvis points to the backside. This is the most common type, and it is very rare to have an excessive rotation of 360°.

　　2, Abdominal midline position:It is caused by incomplete rotation, with the renal pelvis pointing to the anterior-inferior direction and the renal pelvis pointing to the posterior-lateral direction.

　　3, Dorsal position:The kidney rotates 180°, the renal pelvis facing the backside, which is the least common type.

　　4, Lateral position:Renal rotation greater than 180° but less than 360°, or reversal by 180°, with the renal pelvis pointing outward and the renal pelvis pointing to the midline.

　　Complications of renal rotation abnormality:Generally, one side of the rotational abnormality is accompanied by abnormality on the other kidney, such as ectopia with fusion, horseshoe kidney, etc.

　　Renal rotation abnormality itself does not produce specific symptoms. However, excessive fibrous tissue surrounding the renal pelvis, renal pelvis ureteral junction, and upper ureter, as well as additional vessels compressing can cause obstruction, leading to symptoms of hydronephrosis or intermittent renal colic, and may also appear hematuria, infection, and calculus. It often occurs simultaneously with ectopic kidney, which can cause compression of renal vessels or ureters, leading to corresponding clinical manifestations.

　　Kidney malrotation itself does not produce specific symptoms, but excessive fibrous tissue surrounding the renal pelvis, renal pelvis and ureteral junction, and upper ureter, as well as additional vascular compression can cause obstruction, leading to symptoms of hydronephrosis or intermittent renal colic, and may also cause hematuria, infection, and stones. It often occurs with ectopic kidney, which can cause compression of renal vessels or ureters, resulting in corresponding clinical manifestations.

　　There is currently no effective preventive measure for this disease; early detection and diagnosis are the key to prevention and treatment. If there are no symptoms and no hydronephrosis, treatment should not be used. If there are complications such as obstruction or vesicoureteral reflux, treatment of the associated anomalies is required.

　　Urinalysis and microscopic hematuria can be induced or exacerbated by vigorous activity.

　　1. X-ray Examination

　　Excretory urography shows abnormal direction of the renal pelvis and calyces, the renal pelvis is flat and elongated, the renal long axis angle with the midline is reduced (normal about 16°) or parallel to the midline, the upper 1/3 ureter is outwardly displaced, and sometimes there are signs of narrowing, twisting, or malposition of the renal pelvis and ureteral junction, and compression by accessory vessels.

　　2. CT Examination

　　It can clearly show the abnormal direction of the renal pelvis, and according to the direction of the renal pelvis, it can be determined whether this abnormal rotation of the kidney is anterior, anterior-mid, posterior, or lateral.

　　1. Foods Good for Kidney Malrotation

　　Eat light, easy-to-digest foods, fresh vegetables, and moderate amounts of fruit, drink water appropriately. Pay attention to balanced nutrition in diet.

　　2. Foods to Avoid for Kidney Malrotation

　　Avoid overeating, eating unclean food. Avoid seafood, beef, mutton, spicy and刺激性 food, alcohol, and all things that cause heat: five-spice powder, coffee, coriander, etc. Avoid all tonics, tonics, and easily overheating foods such as chili, chocolate, etc.

　　(The above information is for reference only; for details, please consult a doctor.)

　　1. Treatment Plan for Kidney Malrotation

　　If there are no symptoms and no hydronephrosis, there is generally no need for treatment. If there are complications such as obstruction or vesicoureteral reflux, treatment of the associated anomalies is required.

　　2. Prognosis of Kidney Malrotation

　　The kidney will not be affected by its function due to malrotation, but it may only lead to the appearance of stones and effusions.