Table of ContentsView AllTable of ContentsCausesWhen to See a Healthcare ProviderDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Causes
When to See a Healthcare Provider
Diagnosis
Treatment
Frequently Asked Questions
The pain may be described as dull and throbbing or sharp and severe, depending on the underlying cause.It is usually deeper than back pain and located on the upper back, just below the ribs.
Kidney pain is classified asunilateralif one kidney is affected orbilateralif both kidneys are affected. The cause can be intrinsic (occurring within the kidneys), prerenal (related to the amount of blood flowing into the kidneys), or postrenal (related to obstruction or disorder below the kidneys).
The causes of kidney pain are extensive and can be broadly characterized as either an infection, trauma, obstruction, or growth.
Kidney Infection
Symptoms include:
Kidney Trauma
As many as 10% of abdominal injuries will sustain damage to the kidneys. Vehicle accidents, physical assaults, and severe falls account for the majority of renal traumas.
These injuries are not always overtly symptomatic, and some may cause dull pain. There may or may not be any signs of bruising or physical injury. With that being said, touching the kidney area will usually cause pain.
Symptoms that warrant emergency treatment include fever, blood in the urine, an inability to urinate, decreased alertness,tachycardia(rapid heart rate), and abdominal pain and swelling.
Renal Obstruction
Renal obstruction can occur in the kidneys or as the result of urinary blockage downstream. Those that affect the ureters may cause unilateral or bilateral pain. A blockage downstream in the bladder or urethra tends to impact both kidneys.
When an obstruction occurs for whatever reason, the kidneys will begin to swell, a condition referred to ashydronephrosis. Symptoms include pain in the flank, groin, or abdomen alongside fever, dysuria, urinary urgency, and nausea.
Renal Tumors or Cysts
Renal tumors or cysts do not typically cause pain unless the growth is advanced or extensive.
The most common growths in the kidneys include:
By and large, renal tumors, whether benign or cancerous, do not cause pain until they are large enough to compromise the structure of the kidney. It is at this stage that the pain will usually be persistent, aching, and likely to worsen over time.
If cancer is involved, persistent malaise and unexplained weight loss are telltale signs suggestive of an advanced malignancy.
PKD may be symptom-free until the cysts cause structural damage to the kidney. In addition to flank pain, which is usually bilateral, PKD may cause progressively worsening symptoms, including headaches, high blood pressure, hematuria, abdominal pain and swelling, recurrent kidney stones, recurrent UTIs, and renal failure.
As opposed to many of the other renal conditions, PKD is associated with excessive urination (polyuria) rather than impaired urination.The most common form of PKD, known as autosomal dominant PKD, manifests with symptoms between ages 30 and 50. It is responsible for 10% of cases of end-stage renal disease.
Even if a kidney infection is mild, it can sometimes progress and lead tobacteremiaif left untreated. This is a condition in which a local bacterial infection “spills over” over into the bloodstream, causing systemic and potentially life-threatening symptoms, including irregular body temperatures, disruptions in breathing, a severe drop in blood pressure, and shock.
Given that acute pyelonephritis can strike in as little as two days, a rapid response is essential.
Get medical attention if you experience a dull, persistent pain alongside symptoms such as painful urination, chronic fatigue, or unexplained weight loss. If you are suddenly unable to urinate, this may be a sign of an obstruction in need of urgent care.
What is a Nephrologist? When to See One and What to Expect
Only a medical evaluation can confirm a kidney condition or pinpoint the cause of a kidney pain. There are no reliable self-exams or tests to do at home. The diagnostic tools include lab and urine tests to evaluate your body chemistry and imaging tests to identify growths or other structural issues.
Labs and Tests
Blood tests will also be used to evaluate your kidney function.
These include:
Post Comment
Abnormalities in these values would indicate that the kidneys are not working as they should.
A blood test known aserythrocyte sedimentation rate (ESR)may be used to check for inflammation, while a urine culture can help isolate and identify specific bacterial or fungal infections.
Imaging Tests
Imaging tests are used to visualize the kidneys and adjacent structures. They can identify irregularities in the shape or structure of the kidneys, identify cysts and solid tumors, or point to the location of a bleed or obstruction.
Among the tests commonly used:
Other Procedures
If imaging tests don’t provide a clear image of an obstruction or disorder of the lower urinary tract, the healthcare provider may recommend a procedure known ascystoscopy. This involves the insertion of a flexible or rigid scope into the urethra to view the bladder and is commonly used to help diagnose bladder stones, cystitis, strictures, and cancer.
Cystoscopy is performed under local anesthesia and may cause pain and mild bleeding. Infection is also a possible complication.
If there is an abnormality in the ureter or inside the kidney, you may get a ureteroscopy, which is done under anesthesia. This is when a urologist inserts a small flexible or rigid tube from your bladder all the way up into the ureter and kidney.
If cancer is suspected, a biopsy may be performed to obtain a sample of cells from a growth. It can be performed with a fine needle aspiration (FNA), in which a narrow needle is inserted into a tumor with the aid of an ultrasound, or a core needle biopsy (CNB), which utilizes a thicker, hollow-core needle.
Core needle biopsy is generally considered more reliable and accurate for diagnosing renal cancer compared to fine needle aspiration.
Differential Diagnoses
People will often be surprised at how high up the kidneys are in the back. In many cases, a persistent pain will be incorrectly attributed to the kidneys when it is, in fact, muscle or skeletal problem. To this end, healthcare providers will often need to explore other causes of flank pain if urinalysis and other tests do not suggest a renal disorder.
Examples include:
Kidney pain is not a typical sign of kidney failure. With chronic kidney disease (CKD) or acute renal failure (ARF), you are more likely to feel pain in your joints and muscles (due to the build-up of toxins and depletion of electrolytes) than in your kidneys.
The treatment of kidney pain varies based on the causes. Severe disorders typically require the care of a nephrologist (kidney specialist) or a urologist (urinary tract specialist).
Most kidney infections are bacterial and readilytreated with broad-spectrum antibiotics.Fungal and viral infections can affect people who have compromised immune systems, including organ transplant recipients and people with advanced HIV.
A urine culture can help isolate the bacterial strain so that the most appropriate antibiotic is chosen. The most commonly prescribed antibiotics include ampicillin, amoxicillin, ciprofloxacin, and levofloxacin.Severe cases may require intravenous rather than oral antibiotics. Resistant bacterial strains may require combination antibiotic therapy or more potent antibiotics like carbapenem.
During treatment, you’ll need to drink plenty of water to promote urination and help flush the upper and lower urinary tract.
When to Go to the Hospital for a Kidney Infection
Low and moderate grade injuries can often be treated with observation, serial imaging, and extended bed rest. Severe injuries may require surgical repair, including the placement of renal stents to open obstructed vessels. Selective embolism, in which a chemical agent or metallic coil is used to block a blood vessel, may help control bleeding from select parts of the kidney.
A surgical procedure known asnephrectomymay be needed to remove one or, less commonly, both kidneys if repair is not possible. While you can function normally with just one kidney, the removal of both would require you to be placed ondialysisuntil an organ donor can be found.
If the blockage is from an infection, then antibiotics may be given through an IV or orally. If the blockage is from a stone, then you may need a procedure toremove the stone. If the blockage is from a tumor or mass in the lining of your ureter or kidney, a biopsy will be needed.
Depending on the findings, treatment may involve selective embolism to reduce the size of a tumor (essential “starving” the tumor of the blood needed for growth) or nephrectomy to remove part or all of the affected kidney.
There are no treatments for PKD. Treatment is focused on avoiding complications (including high blood pressure, renal infection, kidney failure, andbrain aneurysm) and routine disease monitoring.
Tumors of the kidneys can be in the actual meat of the kidney (where the blood is filtered into the urine) or in the inside lining of the kidney (where urine collects).
Flank pain is located on the sides and back of your torso, below your ribs and above your pelvis. The pain is usually worse on one side of the body, but it can affect both sides.
It sometimes won’t cause any symptoms. When it does, you may experience flank pain along with fever, blood in the urine, dark urine, or frequent urination. It might also cause high blood pressure if it’s keeping your kidney from filtering extra fluid from your blood.
Learn MoreHow Much Water Is Too Much?
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