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Hydronephrosis is a common condition that may be diagnosed while your child is still in the womb or after birth. It may resolve itself before or soon after delivery, but sometimes it may cause problems after birth or as your child grows. If you have been told your child has hydronephrosis, our pediatric urologists and nephrologists can diagnose the cause of your child’s condition and manage the problem as needed. If hydronephrosis is diagnosed before your child is born, we work with your prenatal team to plan any additional imaging before birth and develop a plan for assessment and treatment, if needed, after delivery.

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Expert Care for Hydronephrosis

The term hydronephrosis means “water in the kidney.” If there is a blockage present in your child’s urinary system, the kidneys can swell from a backup of urine, known as reflux. 

Finding the Cause Is the First Step
Finding the cause of your child’s hydronephrosis is the first step in their treatment. It may be caused by a blockage in the flow of urine at some point in your child’s urinary tract or a problem with the valve in the ureter that causes urine to flow backward from the bladder (reflux). Sometimes, these problems can affect the development and function of one or both kidneys.

Your Child Is in Good Hands
These conditions may be initially diagnosed during a routine pregnancy ultrasound. Or your child may experience symptoms, such as admominal pain or frequent urinary tract infects (UTIs) that will prompt your child's doctor to refer you to a pediatric urologist. In either case, you are in good hands. Our pediatric urologists work closely with obstetricians, pediatricians, and nephrologists to give your child comprehensive care.

If Your Child Needs Surgery
Surgery is usually not needed for hydronephrosis, but if your child needs surgery, you can feel confident knowing your child will receive the most effective, least-invasive care possible. Duke Children’s is verified as a Level I Verified Children’s Surgery Center by the American College of Surgeons. This designation recognizes our commitment to providing the safest and highest-quality surgical care to our young patients. We make sure you understand the procedure and that you know what to expect before, during, and after surgery. We discuss what’s right for your child, answer all your questions, and do everything we can to make the experience as worry-free as possible.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests and Treatments


Most children with hydronephrosis do not need medications, but in some cases, antibiotics are recommended to prevent infection and minimize kidney damage.


In a small number of children, surgery may be recommended to repair reflux or correct blockages if your child has recurrent UTIs, kidney damage, or reduced kidney function. Whenever possible, we use minimally invasive techniques, such as robotic-assisted laparoscopy, that involve small incisions. This approach minimizes scarring, allows your child to go home sooner, and helps your child recover faster.

Ongoing Monitoring

Often, children with hydronephrosis need ongoing monitoring to make sure their kidneys are functioning properly. This can be done with regularly scheduled ultrasounds of the kidneys and bladder during your child’s first years of life. Monitoring helps us find potential problems at the earliest stages. If a problem is identified, other types of X-rays and more advanced renal scans may be recommended to better diagnose the problem.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 04/02/2024 by