Floating Kidney – A Rare Case of Nephroptosis

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Floating Kidney
BMJ Case Reports

A rare case of floating kidney in a young healthy woman

A 28-year-old woman presented to the hospital with complaints of right abdominal pain that was intermittent in nature. The pain exacerbated on standing upright from a supine or sitting position. Moreover, she described the feeling of a ball rolling inside her when she changed her position. In addition, she recalled that the pain decreased in intensity during the last trimesters of her pregnancies.

The woman was in chronic distress since she had consulted numerous doctors for her complaints over the past six years. However, none were able to diagnose her based on her symptoms.

Examination and Investigations

The doctors examined her abdomen but it was inconclusive. Furthermore, they also looked at her previous labs and imaging. They were normal.

Based on her symptoms, the doctors performed an intravenous pyelography, which is a fluoroscopic X-ray that provides moving anatomical imaging of the urinary tract. It revealed the inferior movement of her kidney during the change in position from supine to upright. Doctors made a diagnosis of nephroptosis.

Treatment

The doctors treated the patient with nephropexy. This procedure involves surgically fixing the floating kidney. The surgery was uneventful, and she was discharged right after it. She followed up after four weeks with no complications.

What is a floating kidney?

A floating kidney also called nephroptosis is a medical condition due to the absence of perirenal fat. In this condition, the kidney moves inferiorly (more than 5 cm and crosses two vertebral bodies) during a change in position from supine to upright. Furthermore, it is a disease that affects thin and lean women. However, it is mostly diagnosed incidentally and remains asymptomatic in the majority of the cases. The most common symptoms are abdominal pain and relief of symptoms during pregnancy.

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