Kidney pain is classified asunilateralif one kidney is affected orbilateralif both kidneys are affected.
Acute pyelonephritis strikes suddenly and severely, often over the span of two days.
Chronic pyelonephritis is recurrent and usually milder.
Illustration by Alexandra Gordon, Verywell
If symptoms do develop, they may include a dull ache in the flank accompanied bymalaiseand a low-grade fever.
The kidneys are located in a vulnerable position in the abdomen.
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.
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.
The symptoms can vary by the location and severity of the obstruction.
The pain would most often be unilateral and accompanied by either gross (visible) hematuria or microscopic hematuria.
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.
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.
Given that acute pyelonephritis can strike in as little as two days, a rapid response is essential.
If you are pregnant, don’t assume that persistent back pain is pregnancy-related.
If accompanied by symptoms of infection or changes in urination, call your healthcare provider immediately.
There are no reliable self-exams or tests to do at home.
Labs and Tests
Aurinalysisis central to the diagnosis of any renal disorder.
Blood tests will also be used to evaluate your kidney function.
Imaging Tests
Imaging tests are used to visualize the kidneys and adjacent structures.
Cystoscopy is performed under local anesthesia and may cause pain and mild bleeding.
Infection is also a possible complication.
If cancer is suspected, a biopsy may be performed to obtain a sample of cells from a growth.
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.
Examples include:
Kidney pain is not a typical sign of kidney failure.
Treatment
The treatment of kidney pain varies based on the causes.
A urine culture can help isolate the bacterial strain so that the most appropriate antibiotic is chosen.
Resistant bacterial strains may require combination antibiotic therapy or more potent antibiotics like carbapenem.
Severe injuries may require surgical repair, including the placement of renal stents to open obstructed vessels.
Treatments may need to be done in a staged fashion.
In acute or emergency controls.
tubes may be placed to bypass the blockage.
Tubes can be placed from your back directly into your kidney (nephrostomy tube).
A tube can also be placed up into the ureter and kidney through your bladder (ureter stent).
Both these tubes can help open or remove the blockage to help your kidney drain urine properly.
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.
Treatment options include chemotherapy, radiation therapy, immunotherapy, and targeted therapy.
There are no treatments for PKD.
The pain is usually worse on one side of the body, but it can affect both sides.
It sometimes won’t cause any symptoms.
In some cases, yes.
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