Symptoms And Treatment Of Diabetes

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TERMINOLOGY CLINICAL CLARIFICATION5 • Hydronephrosis is the anatomic finding of dilated renal pelvis and renal calyces in one or both kidneys resulting from urinary obstruction, vesico-ureteral reflux (VUR), neurogenic bladder dysfunction, or as a congenital or acquired mega-ureter. • In common clinical usage the term hydronephrosis is used to indicate dilation of the ureter(s) as well as the renal pelvis, though technically that condition should be described as hydroureteronephrosis. CLASSIFICATION • International Reflux Study system6 ○ Grades of vesico-ureteral reflux and associated hydroureteronephrosis – One: reflux up to proximal ureter, slight dilation and tortuosity – Two: reflux into the renal pelvis, scant dilation and tortuosity – Three: reflux into the renal pelvis, notable dilation and tortuosity – Four: reflux into the renal pelvis with clubbing of renal calyces, significant dilation and tortuosity – Five: reflux into the renal pelvis, clubbing, dilation and distension of tortuous megaureter DIAGNOSIS CLINICAL PRESENTATION7 • History ○ The patient may be asymptomatic, complain of voiding symptoms (e.g., urinary frequency, urgency, nocturia), recurrent urinary tract infections or bladder spasm (intense involuntary contraction of the bladder) ○ Symptoms in children are vague and generalized in nature (e.g., "don 't feel good") ○ Fever, chills if urinary tract infection is present ○ Nausea, vomiting, abdominal pain or flank pain in acute obstruction (e.g.,

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