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Twinges in kidneys. Kidney Pain: Causes, Symptoms, and When to Seek Medical Attention

by alexxlab

What are the common causes of kidney pain. How can you distinguish kidney pain from back pain. When should you seek medical attention for kidney discomfort. What are the symptoms associated with kidney issues. How are kidney problems diagnosed and treated.

Understanding Kidney Pain: Location and Characteristics

Kidney pain is often misunderstood and confused with other types of discomfort, particularly back pain. To properly identify and address kidney issues, it’s crucial to understand where kidney pain is typically felt and what it feels like.

Where is kidney pain located?

Kidney pain is generally experienced in the following area:

  • Near the middle of your back
  • Just under your ribcage
  • On each side of your spine

It’s important to note that pain in these areas doesn’t always indicate a kidney problem. The kidneys are surrounded by muscles, bones, and other organs, making it challenging to pinpoint the exact source of discomfort.

What does kidney pain feel like?

Kidney pain typically manifests as:

  • A dull ache that intensifies with gentle pressure
  • Pain that can be felt on one or both sides of the back
  • Discomfort that is deep within the body

If you experience persistent pain in the kidney area, it’s advisable to consult with a healthcare professional for proper diagnosis and treatment.

Differentiating Kidney Pain from Back Pain

Given the proximity of the kidneys to the back muscles, it’s easy to confuse kidney pain with back pain. However, there are several key differences that can help distinguish between the two:

Kidney Pain Characteristics:

  • Felt high on the back and deep within the body
  • Generally described as a dull ache
  • Can occur on one or both sides
  • Typically persistent, regardless of body position or rest

Back Pain Characteristics:

  • Usually felt in the lower back
  • May radiate down one leg
  • Often described as a sharp or stabbing sensation
  • Tends to worsen with certain activities (e.g., bending, lifting)
  • May improve with changes in body position or rest

Understanding these distinctions can help you better communicate your symptoms to a healthcare provider and receive appropriate care.

Common Causes of Kidney Pain

Kidney pain can stem from various underlying conditions. Identifying the cause is crucial for determining the appropriate treatment. Here are some of the most common reasons for kidney discomfort:

Kidney Stones

Kidney stones are a frequent cause of kidney pain. These hard deposits form when waste in the blood crystallizes and accumulates in the kidneys. Small stones may pass through the urinary tract without incident, while larger ones can cause severe pain and may require medical intervention.

Urinary Tract Infections (UTIs)

UTIs occur when bacteria enter the urinary system, causing inflammation and pain. While most UTIs affect the bladder and urethra, they can sometimes spread to the kidneys, leading to more severe symptoms.

Dehydration

Insufficient fluid intake can sometimes result in kidney pain. Dehydration can occur due to excessive sweating, vomiting, diarrhea, or certain medical conditions like diabetes.

Kidney Infections

Kidney infections, also known as pyelonephritis, typically develop when bacteria from a lower urinary tract infection ascend to the kidneys. These infections require prompt medical attention to prevent kidney damage.

Kidney Injury

Physical trauma to the kidney area, such as from a fall, accident, or contact sports, can cause kidney pain. The severity of the pain depends on the extent of the injury.

Kidney Cancer

While less common, kidney cancer can cause pain in the side, back, or abdomen. Early-stage kidney cancer may not produce noticeable symptoms, underscoring the importance of regular check-ups.

Polycystic Kidney Disease

This genetic condition causes fluid-filled cysts to develop in the kidneys, leading to enlargement and potential pain in the back or side.

Recognizing Symptoms Associated with Kidney Pain

Kidney pain often accompanies other symptoms that can indicate the severity of the underlying condition. Being aware of these symptoms can help you determine when to seek medical attention:

  • Fever
  • Blood in urine (hematuria)
  • Pain or burning sensation during urination
  • Body aches or chills
  • Fatigue
  • Nausea or vomiting

If you experience any of these symptoms alongside kidney pain, it’s crucial to consult a healthcare provider promptly. These signs may indicate a serious kidney problem that requires immediate medical intervention.

Diagnosis and Treatment of Kidney Pain

When you visit a healthcare provider for kidney pain, they will likely perform a series of tests and examinations to determine the underlying cause. The diagnostic process may include:

Physical Examination

Your doctor will palpate the kidney area to check for tenderness and swelling. They may also ask about your medical history and recent symptoms.

Urinalysis

A urine sample can reveal the presence of blood, bacteria, or other abnormalities that might indicate a kidney problem.

Blood Tests

Blood work can help assess kidney function and detect signs of infection or other systemic issues.

Imaging Studies

Ultrasounds, CT scans, or MRIs may be ordered to visualize the kidneys and surrounding structures, helping to identify stones, tumors, or other abnormalities.

Treatment for kidney pain depends on the underlying cause and may include:

  • Antibiotics for bacterial infections
  • Pain management medications
  • Increased fluid intake to help pass kidney stones
  • Lithotripsy or surgical intervention for large kidney stones
  • Lifestyle modifications to prevent future kidney issues

Your healthcare provider will develop a personalized treatment plan based on your specific diagnosis and overall health status.

Prevention Strategies for Kidney Health

While not all kidney problems can be prevented, there are several steps you can take to promote kidney health and reduce the risk of developing painful conditions:

Stay Hydrated

Drinking an adequate amount of water each day helps flush toxins from your system and reduces the risk of kidney stone formation.

Maintain a Balanced Diet

A diet rich in fruits, vegetables, and whole grains can help support kidney function. Limiting sodium and processed foods is also beneficial.

Exercise Regularly

Physical activity helps maintain a healthy weight and promotes overall cardiovascular health, which in turn supports kidney function.

Limit Alcohol and Avoid Smoking

Excessive alcohol consumption and smoking can damage kidney tissue and impair function over time.

Manage Chronic Conditions

If you have diabetes, high blood pressure, or other chronic health issues, work closely with your healthcare provider to keep these conditions under control, as they can impact kidney health.

When to Seek Immediate Medical Attention

While some causes of kidney pain may resolve on their own or with conservative treatment, certain symptoms warrant immediate medical attention. Seek emergency care if you experience:

  • Severe, persistent pain in the kidney area
  • High fever accompanied by kidney pain
  • Difficulty urinating or complete inability to urinate
  • Visible blood in the urine
  • Severe nausea and vomiting that prevent you from keeping fluids down
  • Signs of sepsis, such as confusion, rapid heartbeat, or difficulty breathing

These symptoms may indicate a severe kidney infection, obstruction, or other critical conditions that require prompt medical intervention to prevent complications.

Long-term Management of Kidney Health

For individuals who have experienced kidney pain or have been diagnosed with a kidney condition, long-term management is crucial for maintaining kidney health and preventing future issues. Consider the following strategies:

Regular Check-ups

Schedule routine appointments with your healthcare provider to monitor kidney function and address any concerns early on.

Medication Management

If you’re prescribed medications for kidney-related conditions, take them as directed and report any side effects to your doctor.

Lifestyle Modifications

Implement and maintain healthy lifestyle changes, such as a balanced diet, regular exercise, and stress management techniques.

Stay Informed

Educate yourself about your specific kidney condition and stay up-to-date on the latest treatment options and preventive measures.

Support Network

Consider joining a support group or connecting with others who have similar kidney issues to share experiences and coping strategies.

By taking a proactive approach to kidney health and working closely with your healthcare team, you can minimize the risk of future kidney pain and maintain optimal renal function for years to come.

Kidney Pain: Causes, Why kidneys hurt, and When to seek care

Learn about what causes kidney pain, what it feels like, where you may feel it in your body, how to tell kidney pain from back pain and when to talk to your doctor about treatment.

Kidney pain can have many causes. It may be a sign of an infection, injury or another health problem, such as kidney stones. Because of where your kidneys are in your body, kidney pain is also often confused with back pain. Talk to your doctor to find out what is causing your kidney pain and to find the right treatment.

Where do I feel kidney pain?

You feel kidney pain in the area where your kidneys are located: Near the middle of your back, just under your ribcage, on each side of your spine. Your kidneys are part of the urinary tract, the organs that make urine (i.e., pee) and remove it from your body. The urinary tract is made up of the kidneys, ureters, bladder and urethra.

You may feel kidney pain on only one side or both sides of your back. Having pain in these areas does not always mean there is something wrong with your kidneys. Because there are muscles, bones and other organs around your kidneys, it can be hard to tell what exactly is causing your pain. If you have constant pain you think may be caused by your kidneys, talk to your doctor.

What does kidney pain feel like?

Kidney pain often feels like a dull ache that gets worse if someone gently presses on that area. While it is more common to feel kidney pain on only one side, some health problems may affect both kidneys and cause pain on both sides of your back.

Kidney pain vs. back pain

Because of where your kidneys are in your body, it is easy to confuse kidney pain and back pain. How can you tell the difference?

Kidney pain:

  • Is felt high on your back and deep in your body
  • Feels dull
  • Can happen on one or both sides
  • Likely will not go away when you shift your body or rest

Back pain:

  • Is usually felt in your lower back
  • May shoot down one leg
  • Feels more like a stabbing pain
  • Gets worse when you do certain activities, like bending over or lifting something heavy
  • May ease when you shift your body or rest

What causes kidney pain?

Kidney pain has many possible causes. Your doctor can help you find out what is causing your pain and work with you on the best way to treat it.

Kidney stones

Kidney stones are one of the most common causes of kidney pain. Kidney stones happen when waste that builds up in your blood and sticks together in your kidneys to form clumps. Small kidney stones may move through your urinary tract and come out with your urine. However, larger stones can be very painful to pass, or you may need surgery to have them removed.

Urinary tract infection 

Urinary tract infections (UTIs) are caused by bacteria in your urinary tract and can cause pain when you urinate. Most UTIs happen in the bladder and the urethra. UTIs can also cause a fever and the need to urinate often.

Dehydration 

Dehydration (not having enough water in your body) can sometimes cause kidney pain. Dehydration can happen through sweating a lot, throwing up, diarrhea, urinating too much or certain health conditions such as diabetes.  

Kidney infection

Kidney infections are caused by bacteria that usually spread to your kidneys from another part of your urinary tract, for example, if you have a urinary tract infection. Women are more likely to have kidney infections because of the way their bodies are built. If you think you have a kidney infection, call your doctor — it needs to be treated right away to help prevent kidney damage.

Kidney injury

Sometimes, your kidneys can get hurt, for example if you have a fall or accident or during sports like football, boxing or soccer. Pain from a kidney injury could be mild or very strong, depending on how badly your kidneys are hurt. Kidney injury, also known as kidney trauma or kidney bruising, is different from acute kidney injury. 

Kidney cancer

Kidney cancer may not cause any pain or other symptoms early on. As the cancer gets worse, you may notice pain that does not go away in your side, back or belly. You may also have a fever or blood in your urine. However, these symptoms do not always mean you have kidney cancer — many other health problems can also cause these symptoms. 

Polycystic kidney disease

Polycystic kidney disease is a genetic condition that causes cysts (growths filled with fluid) to grow in your kidneys. These cysts make the kidneys much larger than they should be and can cause pain in your back or side.

What are the symptoms of kidney pain?

Depending on what is causing your kidney pain, you may have other symptoms as well. Some of these could mean you have a serious kidney problem. Call your doctor right away if you have any of these symptoms along with kidney pain:

  • Fever
  • Blood in your urine
  • Pain when you urinate
  • Body aches or chills
  • Tiredness
  • Feeling sick to your stomach or throwing up

How is kidney pain treated?

The treatment for kidney pain depends on what is causing it. Be sure to call your doctor if you have any kidney pain. Your doctor may do:

  • A urine test to check for signs of infection
  • Imaging tests, such as an ultrasound or CT scan, to see if your kidneys are injured

Once you know what is causing your pain, your doctor can work with you to find the right treatment.

Kidney Pain vs. Back Pain: Why Kidneys Hurt

Written by Susan Bernstein

  • What Is Kidney Pain?
  • Symptoms of Kidney Pain
  • Causes of Kidney Pain
  • Kidney Pain vs. Back Pain
  • Kidney Pain Treatment

Kidney pain is discomfort that comes from the area where your kidneys are. It’s often described as a dull ache, you feel in your sides, back, or belly. But pain in these areas isn’t always a sign of a kidney issue. It’s easy to mistake kidney pain for ordinary back pain. But there are some differences in how kidney pain feels and where it’s located compared to back pain.

Kidney pain has many possible causes, and some could be serious. It’s important to let your doctor know if you notice pain that you think may be coming from one or both of these organs.

Where are your kidneys?

Your kidneys are two small organs shaped like beans. You have one on each side of your body. They’re each about the size of your fist. They’re below your rib cage on both sides of your spinal cord.

Your kidneys have important jobs. They clean out water, acids, and waste from your blood. They make urine so your body flushes out the waste. If they’re diseased or damaged in some way, they can’t do their work to maintain a healthy balance of salts, minerals like calcium, and water in your blood.

Your kidneys also make hormones that help you manage your blood pressure, keep your bones strong, and make red blood cells.

So it’s important to watch for any signs of kidney disease or damage, like pain.

Kidney pain symptoms include:

  • A dull ache that’s usually constant
  • Pain under your rib cage or in your belly
  • Pain in your side; usually only one side, but sometimes both hurt
  • Sharp or severe pain that may come in waves
  • Pain that can spread to your groin area or belly

Other symptoms that can happen with kidney pain

The symptoms of your kidney pain depend on its cause. With kidney pain you may also have:

  • Fever
  • Vomiting
  • Pain when you pee
  • Cloudy urine
  • Blood in your urine

Kidney pain has many possible causes. These organs are connected to others like your bladder and ureters, where you store and get rid of urine.

Kidney stones. Intense, sudden, stabbing pain may be a kidney stone. These are mineral deposits that can grow large enough to block a ureter, a tube that connects your kidney and bladder. If that happens, you’ll feel sharp pain or cramps in your back or side. It can also spread out to your groin. As you try to pee out the stone, you might feel waves of pain.

Kidney infection. Also called pyelonephritis, this infection could cause discomfort in one or both kidneys. You may feel pain in your back, in your side or both sides under your ribs, or in your groin. You’ll also have a fever. Urinary tract infections also cause discomfort in this organ.

Kidney swelling. This condition, called hydronephrosis, can happen if your kidneys are blocked. Your urine can’t drain the way it should and builds up in your kidneys. This can happen in one or both kidneys and sometimes it causes pain.

Kidney cysts. You may not feel a simple kidney cyst until it grows larger. Once it gets big, you might feel a dull pain in your side or back, or feel pain in the upper part of your belly.

Polycystic kidney disease. This genetic disease causes many cysts to grow in your kidneys. They may cause you to feel a pain in your back or side.

Kidney cancer. Tumors in your kidney may not cause any discomfort early on. As the cancer gets worse, you may notice pain in your side, back, or belly that doesn’t come and go or get less intense.

Benign kidney tumor or mass. A renal mass is a noncancerous tumor or growth. It feels like pain in your flank, between your ribs and your hips on your side. You’ll also have low back pain on one side of your body that lingers.

Renal vein thrombosis. A blood clot can form in one of the veins in your kidney. It causes severe, ongoing pain in your flank or side. You may feel spasms of pain at times too. The area around the affected kidney between your rib cage and spine could feel sore.

Kidney injury. Many contact sports or vigorous activities like football, boxing, horseback riding, or soccer could put you at risk for a kidney injury.

If this happens, the discomfort might be in either side of your belly or low back. It could range from mild to very strong, depending on how badly you’re injured.

It’s easy to confuse kidney pain for just back pain. How do you know the difference?

Location. It could be your kidney and not your back if you feel it higher on your back. Back problems usually affect your lower back.

Kidney pain is felt higher and deeper in your body than back pain. You may feel it in the upper half of your back, not the lower part. Unlike back discomfort, it’s felt on one or both sides, usually under your rib cage.

It’s often constant. It probably won’t go away when you shift your body. With your back, it might lessen when you adjust your position.

Signs that it’s your back

Back pain:

  • Shoots down one leg
  • Is more likely to be stabbing than dull and constant
  • Gets worse or flares up when you do certain activities, like lifting a box or bending over
  • When you rest or lie down, back pain may ease up
  • Might also be muscle aches

Other symptoms to watch for

Depending on the cause of the pain, you could have other symptoms too. If you have these signs, contact your doctor. You could have a serious kidney problem:

  • Fever
  • Body aches
  • Tiredness

Also, if you recently had a urinary tract infection (UTI), call your doctor. If you have blood in your urine, or if your pain is sudden and unbearable even without signs of blood in your pee, get medical care right away.

To treat your kidney pain, your doctor first needs to find its cause. They may use one or more tests to find out the cause of your pain. These tests include:

  • Urine tests to check your pee for blood, protein, too many white blood cells, and other signs of specific kidney problems
  • An ultrasound or CT scan to look for kidney stones or other physical problems in the kidneys and urinary tract

Once your doctor diagnoses the cause of your kidney pain, they can decide on the best treatment plan for you.

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Renal colic: causes, first aid and treatment

Quiet winter evening (spring, summer or autumn – as convenient), you came home from work, had dinner, drank a glass of your favorite beer and sat comfortably on the couch, focusing on watching TV. Suddenly, you feel discomfort in the lumbar region, which gradually turns into aching, and then into a sharp pain. You are trying to find the position of the body in which the pain will be less pronounced – the effect is zero. The pain does not subside, you begin to roll on the floor or bed. You are shaking, weakness, nausea, vomiting – there is no relief. The abdomen is swollen like a drum, the gases do not go away. There are repeated painful urges to urinate. What it is?! Bad beer?! Fermented cabbage?! No, friends, this is renal colic! What is this? Like this? For what? What to do? Let’s figure it out.

Renal colic (RC) is a collective term that includes several symptoms that indicate a violation of the outflow of urine. The pain that occurs in this case belongs to the category of the most intense and furious. It is almost impossible to endure, the patient may even fall into a state of shock. It must be understood that the appearance of an attack of pain is only a symptom, and a dangerous condition for the health and life of the patient. As a rule, the occurrence of PC indicates urolithiasis and is currently associated with the migration of stones from the calyx or pelvis of the kidney to the ureter.

The mechanism of occurrence of PC : as a result of a violation of the outflow of urine, intrarenal (intrapelvic, to be more precise) pressure increases – figuratively speaking, the kidney inflates like a balloon with water. The pressure of urine on the parenchyma of the kidney leads to a violation of the microcirculation in it, the development of edema. All this together affects the receptors of the sensory nerves of the gate and the fibrous capsule of the kidney, which have a small potential for extensibility, resulting in the occurrence of a characteristic pain attack.

The incidence of PC in the population is 1-12%, with more than half of the cases occurring in the male half of the population. It should be noted that 13% of cases of the total number of patients with renal colic are due to other diseases of the kidneys and ureter (tumors, tuberculosis, hydronephrosis, urovasal conflict, retroperitoneal fibrosis) and are associated with the discharge of blood clots, pus, mucus that close the lumen of the urinary tract.

Colic due to renal pathology , is one of the most severe types of pain that requires urgent diagnosis and treatment. PC, as a rule, occurs suddenly after driving, shaking, drinking plenty of fluids, alcohol. The pains are so severe that patients rush around the room, constantly changing location and posture, which usually does not bring relief to them. This characteristic behavior of the patient often makes it possible to establish a diagnosis “at a distance”.

Pain may radiate to the groin, genitals (scrotum, penis, vagina and labia), aggravated by urination. Depending on the location of the obstruction, false urges to defecate and urinate may occur. The body temperature may rise to subfebrile numbers (37.1 – 37.5 ° C), the heart rate decreases and blood pressure slightly increases. Urine acquires a pink or red color when a stone damages the wall of the ureter or the cavity of the kidney. Pain sometimes lasts for several hours and even days, periodically subsiding.

WHAT TO DO? WHEN YOU HAVE A PK, IT IS NECESSARY TO IMMEDIATELY CALL EMERGENCY!

But it usually takes a long time before the team arrives at the scene. This is not the fault of doctors: traffic congestion, weather conditions, schedule congestion and many other things can prevent you from quickly arriving on call. Therefore, the patient himself and his relatives need to be able to recognize the danger and know what can be taken at the peak of pain, and what can be harmful.

  • First aid for renal colic – providing complete rest to the patient, providing free space. Patients usually rush about in a fit of pain, cannot find a place for themselves, so it is important to create comfortable conditions for them
  • If the pain can be tolerated until the arrival of doctors, then it is better to do without painkillers so that it is easier to make a preliminary diagnosis
  • If the patient is a stone excretor with long-term urolithiasis, and this is not the first attack of renal colic in his life, if there is no increase in body temperature, then you can try placing him in hot water. And pay attention to the fact that the water must be very hot, which only a person is able to withstand

Hot baths are contraindicated in those patients (especially the elderly) who have serious cardiovascular diseases and who have had a stroke or heart attack. For such people, to provide first aid for renal colic, you need to use a hot heating pad placed on the lower back, or mustard plasters placed on the kidney area.

The patient can take 2-3 tablets of No-shpa (Drotaverine), a Ketanov tablet or some antispasmodic (papaverine – 1 tablet). If possible, it is better to administer drugs intramuscularly (Ketorol, Baralgin), and not in the form of tablets – the effectiveness increases several times, the effect of the drug comes faster. In the absence of these drugs, you can use nitroglycerin (half a tablet under the tongue), which also relaxes the smooth muscle muscles, and is able to relieve spasm of the ureter.

Non-steroidal anti-inflammatory drugs effectively relieve pain, in particular Diclofenac – I consider intramuscular administration of 75 mg or rectal administration of a suppository at a dosage of 100 mg to be optimal. Before the arrival of the doctor, it is necessary to write down the medications taken, and control the urine for the passage of calculi (it is best to collect urine in a vessel). If the attack subsides, it is impossible to cancel the call of the medical team, since there is a risk of the attack returning (the stone, if the cause is in it, can advance and then the spasm passes).

It may not always be necessary and beneficial to use painkillers for PC. Manifestations of urolithiasis (UCD) may resemble symptoms of other diseases of the abdominal cavity and retroperitoneal space. It should be noted that the presence of urolithiasis does not exclude the possibility of developing another acute pathology (for example, appendicitis). Therefore, if the attack is atypical, it is better not to do anything until the doctor arrives.

Heat and antispasmodics can exacerbate infectious and inflammatory processes in case of acute appendicitis or other diseases from the group of pathologies with an “acute abdomen” clinic. That is why it is better to wait for an emergency doctor, who will first of all need to exclude such manifestations of an acute abdomen as acute appendicitis, ectopic pregnancy, cholelithiasis, peptic ulcer, etc., which sometimes needs to be done together with doctors of other specialties.

If you have an ovarian cyst, you should tell the ambulance immediately. Particular attention should be paid to a patient with renal colic, if it is a pregnant woman. Treatment of women with renal colic, and even in the “position”, should be carried out only in a hospital. Renal colic in pregnant women is very similar to contractions in the clinic, so it is important not to hesitate and immediately call specialists. Do not forget to immediately say that the patient is pregnant and how long she is, then the team will arrive faster because of the possible threat to the life of the mother and baby.

So, you were examined by an ambulance doctor and diagnosed with renal colic. What to do next?

If the drugs administered by the ambulance doctor did not bring relief, actively insist on your hospitalization in the emergency urology! It’s not a fact that you have renal colic, everyone can be wrong, especially since the ambulance doctor’s first aid kit does not include a portable ultrasound machine and a biochemical laboratory. As a rule, urological hospitals are structural divisions of large medical institutions, where there is a surgical department, a gynecological department, etc. In this medical institution, you can be examined more qualitatively with the involvement of related specialists, as well as provide specialized assistance.

If we managed to remove the pain syndrome, then we don’t relax, the problem has not been solved yet! We are waiting for the morning. We woke up (if we managed to doze off), washed ourselves, shaved and forward – to the urologist!

I recommend contacting medical centers, which, among other things, deal with the problems of treating urolithiasis.

What, first of all, should you pay attention to in the resume of the urologist you applied for an appointment with (you can get such information on the clinic’s website):

  • Does he/she know modern diagnostic methods (ultrasound, X-ray) ICD
  • Clinical experience with minimally invasive and endoscopic treatment of KSD
  • Equipment of the clinic – availability of equipment that meets modern European standards for the quality of care for patients with KSD (remote lithotripter, contact lithotripter, laparoscopic stand)

In such a medical center, a urologist will determine the cause of colic in a short time, assess the degree of risk, and develop an algorithm for your further examination and treatment. It must be understood that renal colic is only a symptom and more often it is a sign of a “blockage” of the urinary tract.

Upper urinary tract obstruction is an extremely dangerous condition, in which it is important to eliminate its cause as soon as possible with the help of competent treatment. Otherwise, the patient’s condition will progressively worsen due to the addition of a secondary infection, an increase in the level of intoxication of the body, not to mention a constant and unbearable pain syndrome. In some cases, it is with the release of the upper urinary tract that treatment begins. Why do I focus on the timing of the start of treatment? In the first hours after the onset of an attack of renal colic, an infectious inflammatory process does not yet have time to develop in the kidney – the situation is “uncomplicated”.

As a polyclinic urologist usually does: using additional research methods, he determines the size of the calculus, the level of its localization, the degree of obstruction of the upper urinary tract, evaluates changes in urine and blood parameters and prescribes stone expulsion therapy . .. Is this correct?

It is generally accepted in the urological environment that stones up to 7 mm in size are able to move away on their own (Glybochko P.V., 2012). Therefore, a standard scheme of stone-casting therapy is prescribed, and everyone begins to wait for the patient to “give birth” to this vile stone. They wait a day, two, a week, a month, etc. And at this time, repeated attacks of renal colic may occur, which are accompanied by the above symptoms. Which of the urologists can specifically tell the patient when the stone will come out?

After all, the diameter of the ureter in the narrowest part (intramural part) is 2-3 mm, and we kind of want a 5-7 mm stone to come out. Yes, in most cases, such stones come out on their own. But, the question is – how can a patient know that he will fall into the number of this happy “majority”, how long he should wait and suffer at the same time ?! According to foreign authors (Preminger GM., 2007, Miller OF., 1999), the probability of independent discharge of ureteral calculi <5 mm in size is 68%, >5 mm – 47%. The terms of independent discharge of calculi with sizes <2 mm average 31 days, 2-4 mm - 40 days, > 4-6 mm – 39days respectively. Think about these numbers!

Modern minimally invasive and less traumatic methods of treating urolithiasis have radically changed the mentality of a whole generation of urologists, a distinctive feature of today’s essence of which is that regardless of the size and location of the stone, as well as its “behavior”, the patient should and can be rid of it ! And this is correct, since even small, asymptomatic stones located in the cups must be eliminated, since there is always a risk of their growth and the development of chronic pyelonephritis.

One of the most effective and less traumatic methods of treating KSD is extracorporeal shock wave lithotripsy (ESWL). The remote lithotripter crushes kidney and ureter stones using focused, high-intensity acoustic pulses.

Crushing of stone occurs under the action of a shock wave, consisting of pulses of ultra-high and ultra-low pressure. This effect can be compared to the circles that form on the water after a stone falls into it. When the stone touches the water, it forms a high pressure, while pushing the water in all directions, after the stone has sunk, a zone of negative pressure is formed behind it. It is the divergent waves that can be compared with the propagation of a shock wave, under the influence of which the stone is destroyed.

The destruction of the stone occurs in several stages: first, the dense frame of the stone is destroyed, then cracks are formed, penetrating deeper and deeper with each impulse, leading to the destruction of the stone into small fragments. Ultimately, their size does not exceed 3 mm, which allows them to independently and freely exit the urinary system, while relieving the patient of a urinary tract stone.

Locating and focusing uses x-ray image, enhanced on many models of lithotripters by ultrasonic guidance. External shock wave lithotripsy is so minimally invasive that it is used on an outpatient basis (Lopatkin N. A. et al., 1990, Beshchliev D.A., Dzeranov N.K., 1992, Trapeznikova M.F. et al., 1992). At present, many authors have proven the advantages of the method not only over open surgery, but also over percutaneous puncture nephrolithotripsy (Ramadan Salaheddin, 1992, Stepanov VL et al., 1993).

The size of the stone is of paramount importance when performing remote crushing of stones in the kidneys and ureter. This largely determines the number of sessions that must be carried out for the complete fragmentation of the stone. An increase in the size of the stone leads to a decrease in the effectiveness of the primary session of remote crushing of stones.

For example, with stone sizes up to 9 mm, only one session is needed in 80%, and with a size of up to 14 mm, the effectiveness of the initial session is reduced to 64%. The most effective is remote crushing of kidney stones with their size up to 15 mm, and remote crushing of stones in the ureter – with a size of up to 10 mm. With remote crushing of stones in the kidneys and ureter, it is also necessary to take into account the density of the calculus. The denser the stone, the harder it will be to crush it the first time.

Ureteral stones up to 10 mm in size should be crushed remotely (non-contact), the sooner the better and more efficiently!!! It will be much easier and painless for the patient to “give birth” to fragments of calculus and sand after crushing

More than once I have seen a situation where a patient crawls into an office with a wild attack of pain. Within 15 minutes of visual, palpation and ultrasound examination, I make a diagnosis of ureteral calculus. Another 45 minutes I spend a session of remote crushing. And after 1 hour, the patient leaves the ward of the day hospital absolutely healthy, rested, without pain and without a stone. Total: 2 hours!!!

When can we talk about stone expulsion therapy (this is my subjective opinion based on 17 years of clinical experience in the treatment of urolithiasis):

  • There is a clear tendency to discharge of the calculus – already in the first hours of an attack of renal colic, the stone descends into the lower third of the ureter (the ideal variant is the mouth of the ureter), with sonography we see urine emissions from the mouth of the corresponding ureter (even if weakened) and the size of the calculus is not more than 7mm. A day later, sonographic control, control of the general analysis of blood, urine. With repeated attacks of colic, an increase in the degree of obstruction, a deterioration in laboratory parameters – remote crushing (ESL). If the patient feels satisfactory, wait up to 7 days. If the stone did not come out – remote or contact crushing.
  • Ureteral stone up to 7 mm in size, which is not technically possible to crush remotely (lack of sonographic and X-ray visualization of the calculus). At the same time, according to excretory urography, the calculus should be streamlined. Once every 3 days sonographic control, control of the general analysis of blood, urine. If the patient feels satisfactory, we wait a maximum of 2 weeks. In the event of a complication of the situation, or if the calculus has not come out, an endoscopic intervention is performed aimed at removing the calculus or draining the upper urinary tract.

External shock wave lithotripsy (ESWL or ESWL) is currently the gold standard for treating small urinary tract stones. Urolithiasis, undoubtedly, requires treatment, since there is a possibility of developing complications of various severity, leading to a decrease and loss of kidney function and its death. In the presence of high-tech non-invasive methods of treatment, such as remote lithotripsy, trauma and postoperative complications are minimized, and the number of patients who have successfully completed the treatment of urolithiasis tends to 100% every year.

Our clinic actively and successfully performs remote crushing of stones in the kidneys and ureter on a modern high-performance Modulith SLK unit from Storz Medical (Switzerland). Remote crushing of stones is carried out by a specialist with 17 years of experience in minimally invasive treatment of KSD. Remote lithotripsy is performed under intravenous anesthesia with the involvement of anesthesiologists . Thanks to the well-coordinated work of the urologist-anesthesiologist team, crushing is carried out on an outpatient basis – hospitalization is not required. The duration of stay in the clinic is 2-3 hours.

R.P.FEDORISHIN
CANDIDATE OF MEDICAL SCIENCES, UROLOGIST OF THE HIGHER CATEGORY
INTERNATIONAL MEDICAL CLINIC “NEW LIFE”. KYIV.

Kidney pain – causes, symptoms, signs, treatment, what to take, how to remove

Causes

Symptoms

Diagnostics

Treatment

Kidney pain is not a single disease, but a symptom that can appear in a variety of diseases. The main causes of this complaint on the part of the patient are pyelonephritis or glomerulonephritis. However, the pain syndrome can develop against the background of urolithiasis, thrombosis of the veins or renal arteries, as well as with a heart attack.

Pain in the region of the kidneys requires immediate medical attention. Therapists, nephrologists or urologists deal with this problem. It is important to find out the cause that led to the development of this symptom and eliminate it. Treatment of pain alone, for example, with painkillers, will not give the desired result, and soon the symptom will return again.

Causes and triggers

It is difficult to understand on your own why pain in the kidneys appeared – this symptom has many causes and provoking factors. Most often, such a complaint occurs in patients suffering from the following diseases:

  • pyelonephritis is a purulent infectious inflammatory disease that is manifested by poor urinalysis, fever, back pain;
  • urolithiasis;
  • sciatica with exacerbations in the lumbar region;
  • spondyloarthrosis, when dystrophic, non-treatable changes begin to occur in the spine;
  • oncological neoplasms;
  • benign tumors in this area;
  • a renal cyst, which can cause blood in the urine, severe back pain, and the size of the organ increases significantly;
  • renal artery thrombosis – this condition occurs when the main vessel that feeds the kidneys is blocked by a thrombus, which causes severe pain, constipation, nausea and other symptoms;
  • atherosclerosis of large renal vessels;
  • pinched nerve in osteochondrosis.

Pain in the kidneys in women may occur during pregnancy. Often this condition is accompanied by the appearance of protein in the urine, which is the first sign that these paired organs are not doing their job, and the woman urgently needs to consult a gynecologist.

Kidney pain in men may result from trauma, gastrointestinal disease, or stroke. It is important to remember that this symptom does not always indicate that it is the described paired organs that are affected. Sometimes it appears due to diseases of other organs, and then a mandatory consultation of a neurologist, phlebologist or other specialists is required.

Rare provoking factors include both acute and chronic renal failure, nephritis, pyonephrosis and carbuncle of the kidney, genetic anomalies, nephropathy, hepatorenal syndrome.

Symptoms

Kidney pain is rarely an independent symptom. Most often, a patient is diagnosed with fever, chills, nausea or vomiting, frequent urination, itchy skin, high blood pressure, swelling of the face or legs, and poor general health.

When urinating, the urine may become cloudy or have obvious signs of blood. It is impossible to say exactly what signs of pain in the kidneys will disturb a person. It all depends on what disease this symptom was provoked. Therefore, you should go to the doctor as soon as possible to find out the reasons for the development of discomfort in the lower back.

What kind of pain in the kidneys occurs in nature, also depends on the underlying disease. Sensations can disturb constantly or appear only from time to time, be dull or acute, occur on one side or both. Aching and long-term pain occurs in chronic processes, and an increase in discomfort can be influenced by a change in body position, being in a horizontal or vertical position.

Drawing pains usually occur when muscles are injured or damaged. Dull pain speaks of pathologies in the pelvic organs. When the kidneys are lowered, discomfort occurs with any physical effort. Pulsating pain sensations appear during an acute inflammatory process.

Pain in the kidneys often radiates to other areas: lower back, leg, groin, lower abdomen. Also, the patient notes a violation of urination, at night you have to go to the toilet especially often, and during urination, discomfort is noted.

Diagnosis

How to distinguish pain in the kidneys from damage to other organs? Usually, only a doctor can do this during examination and after questioning the patient. It is impossible to independently determine the cause of these unpleasant sensations.

Tests are of great importance for diagnosis. They must be done in the first place and it is not worth pulling with their surrender. The main thing is a urine test. It will show the presence of specific changes that occur in this fluid only with kidney disease. This may be the presence of a large amount of protein, red blood cells, white blood cells, bacteria. Urinalysis can be done by the usual method with a sediment study, or it can be done according to Zimnitsky or Nechiporenko.

A blood test often shows an elevated ESR as well as a high white blood cell count. This indicates the development of the inflammatory process. In a biochemical study, the emphasis is on the level of protein and albumin, as well as creatinine and urea.

An ultrasound is performed to determine how the kidneys are working. It helps to determine the presence of tumors, cysts, as well as the size of the kidneys, find foci of inflammation and understand exactly where the pathological process takes place. Blood flow in paired organs is determined using dopplerography.

Additional methods include radiography with contrast, CT or MRI, as well as urography and biopsy.

Treatment

Kidney pain is often treated in a hospital. The patient is prescribed a special diet with a minimum content of salt and protein. Also, in acute inflammation, bed rest and limitation of physical activity are recommended.

What to take if there is pain in the kidneys, only a doctor can tell. Diuretics are recommended to relieve swelling and normalize diuresis. Corticosteroids effectively eliminate the inflammatory process, which is often the cause of the disease. Hormonal preparations are usually used for glomerulonephritis or ordinary nephritis.

What should I do if my kidney pain is caused by an infectious disease? In this case, it is recommended to take antibiotics, but it is possible to decide on their appointment only after determining the sensitivity to antimicrobial drugs. Self-administration of these drugs can lead to numerous complications. Antihypertensive drugs are used in chronic renal failure, as well as high blood pressure.

How to relieve pain in the kidneys, if it is necessary to do it urgently? The best solution would be drugs of the antispasmodic group. Painkillers for pain in the kidneys are better to choose from the group of NSAIDs. But you can take them only after eating, besides, they have a considerable number of contraindications and you must carefully read the instructions.

Kidney pain pills are not recommended to be taken for too long – if the discomfort does not stop within 1-2 days, you should immediately consult a doctor.

Nephrology surgery is usually done for stones that cannot pass on their own. In cases of severe anomalies in the development of this paired organ or a total lesion of the entire kidney, it is removed with further transplantation.

As a preventive measure, it is recommended to treat all diseases in a timely manner, not neglect annual medical examinations, be sure to pay attention to physical education, avoid hypothermia and reduce the amount of salt consumed to a minimum. It is necessary to stop smoking and abuse alcoholic beverages, always monitor blood pressure and sugar, give urine for analysis once a year and take vitamin-mineral complexes in accordance with age.

The author of the article:

Pavlova Olga Grigorievna

general practitioner, nephrologist

work experience 33 years

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