Hydronephrosis refers to dilation of the renal pelvis and calyces due to obstruction of urine flow, leading to increased pressure within the kidney and potential impairment of renal function. It is a common finding in nephrology practice and may occur in patients of all ages, from infants to older adults. In the UAE, hydronephrosis is frequently associated with kidney stones, prostate enlargement, congenital anomalies, and urinary tract strictures.

The condition develops when urine cannot drain normally from the kidney, causing progressive distension of the collecting system. This back pressure interferes with normal kidney filtration and, if prolonged, results in reduced blood flow, inflammation, and irreversible kidney damage. Hydronephrosis may be unilateral or bilateral and may develop acutely or chronically depending on the cause.

Clinical presentation varies widely. Acute hydronephrosis often causes flank pain, nausea, vomiting, and reduced urine output. Chronic hydronephrosis may be asymptomatic and discovered incidentally during imaging. In advanced cases, patients may develop declining kidney function, recurrent infections, or electrolyte disturbances.

Diagnosis relies on imaging studies, with renal ultrasound serving as the primary diagnostic tool. Additional imaging may be required to identify the underlying cause and assess severity. Laboratory tests help evaluate kidney function and detect complications.

Management focuses on relieving the underlying obstruction and protecting kidney function. Treatment strategies depend on the cause, location, and duration of obstruction. Early intervention often leads to significant recovery of kidney function, while delayed treatment increases the risk of permanent renal damage. Nephrology and urology collaboration is essential for optimal care.