Nephroptosis (Floating Kidney)
Nephroptosis (aka floating kidney or renal ptosis) is an abnormal condition in which the kidney drops down into the pelvis when the patient stands up. The cause is a congenital or traumatic weakness of the connective tissue (the supporting perirenal fasciae) which is supposed to hold the kidney in place. Onset can be in adult life when the connective tissue finally gives way, usually do to sudden violent or semi-violent movement.
Nephroptosis is more common in women than in men. It has been one of the most controversial conditions among doctors in both its diagnosis and its treatments.
Nephroptosis is asymptomatic in most patients. However, nephroptosis can be characterized by violent attacks of colicky flank pain, nausea, chills, hypertension, hematuria and proteinuria. Patients with symptomatic nephroptosis often complain of sharp pains that radiate into the groin. Many patients also suggest a weighing feeling on the abdomen. Pain is typically relieved by lying down. Standing or setting may provoke a drop in blood pressure and faintness which necessitates maintaining the supine position. Diagnosis is suspected based upon patient symptoms and confirmed by intravenous urography, obtaining erect and supine films.
Treatment is surgical (nephroplexy – reattachment of the kidney to its anatomical positoin) to stabilize the kidney, however surgery is not recommended in asymptomatic patients. Laparoscopic nephropexy has recently become available for selected symptomatic patients.