Kidney pain

A typical pain syndrome in urology is pain in the kidneys.

Kidney pain is a symptom of many diseases, which has a wide range of clinical significance: from functional disorders to conditions that threaten the patient's life. Being a common symptom in outpatient practice, kidney pain requires a rational diagnostic strategy, primarily from the standpoint of a general practitioner, who is often the first to encounter such patients.

It is necessary to keep in mind that some patients suffering from kidney diseases (for example, latent chronic glomerulonephritis) may not complain of kidney pain at all. In other cases, patients' complaints may be only general (weakness, fatigue, decreased performance, etc.), which sometimes does not give any reason to suspect kidney damage and conduct a targeted examination. However, with many kidney and urinary tract diseases, there are, as a rule, quite characteristic complaints, among which pain plays an important role.

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Causes kidney pain

Kidney pain can be caused by stretching of the renal capsule (for example, in acute glomerulonephritis), renal pelvis (in acute or chronic pyelonephritis), blockage of the ureter (by a calculus, blood clot) and its kink in some anomalies of the kidney position, spastic contraction of the ureter, ischemia of the renal tissue (in renal infarction).

When analyzing kidney pain, first of all, attention is paid to the localization and irradiation of pain. Thus, in a number of kidney diseases, pain is localized in the lumbar region. Incidentally, we note that for such a common disease as chronic glomerulonephritis in nephrological practice, pain is not at all characteristic. And even in acute glomerulonephritis, they are often defined by patients not as pain in the lumbar region, but as a feeling of heaviness.

Pain in renal colic is localized in the lumbar region and usually radiates to the hypochondrium, spreading further along the ureter to the lateral parts of the abdomen, groin area, genitals, and inner thigh. In case of inflammation in the bladder, pain is felt in the pubic region, and in case of damage to the urethra (for example, in urethritis) - along the urethra.

An important diagnostic sign is the nature of the pain in the kidneys. Thus, in chronic pyelonephritis, the pain is most often aching. When the ureter is blocked by a stone or spasms, causing an acute obstruction of the outflow of urine from the renal pelvis, the pain takes on the character of colic, periodically weakening slightly, and then sharply intensifying again. At the same time, the restless behavior of patients draws attention, who literally cannot find a place for themselves, constantly changing position. Against the background of a severe pain attack, they may reflexively vomit. Sharp, unbearable pain in the lower abdomen, appearing with acute urinary retention, is also of a sharp, unbearable nature.

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In some cases, it is possible to note a connection between the occurrence of kidney pain and some factors. For example, an attack of renal colic is sometimes provoked by a bumpy ride. Pain with a wandering kidney can appear with sudden movements. Pain associated with damage to the bladder and urethra increases with urination.

Pain in renal colic is reduced after the injection of anticholinergics, antispasmodics, the patient taking a hot bath, and sometimes only after the injection of narcotic analgesics. In acute paranephritis, the pain becomes weaker if the patient bends the leg at the hip joint on the affected side.

Patients often complain of an increase (polyuria) or decrease (oliguria) in the amount of urine excreted during the day.

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Pathogenesis

Kidney pain can be a consequence of various diseases and conditions, and the pathogenesis (development mechanism) of this pain depends on the specific cause. Let's consider several main pathological conditions that can cause kidney pain and their pathogenesis:

1. Pyelonephritis: This is an inflammation of the kidneys that can be caused by an infection, most often bacterial. Pathogenesis involves the penetration of bacteria into the kidneys through the urinary tract or blood. Inflammation and infection can damage kidney tissue, causing pain and discomfort.
2. Urolithiasis: The formation of stones in the urinary tract or kidneys (urolithiasis) can lead to blockage of the urinary tract or damage to kidney tissue. Pathogenesis involves the formation and growth of stones, which can cause painful colic and long-term pain.
3. Hydronephrosis: This is a dilation of the renal pelvic system that can occur due to urinary tract obstruction, such as from kidney stones or tumors. Hydronephrosis can cause pressure and stretching of the kidney tissue, leading to pain.
4. Polycystic kidney disease: This is a genetic disorder in which multiple cysts form in the kidneys. The pathogenesis is associated with the constant growth and development of cysts, which can cause an increase in the size of the kidneys and pressure on the surrounding tissues.
5. High blood pressure: High blood pressure can damage the small vessels in the kidneys, which can lead to chronic pain and decreased kidney function.
6. Other Causes: Kidney pain can also be caused by other conditions, including kidney tumors, inflammatory diseases, renal aneurysms, and others.

Forms

Kidney pain can come in many forms and vary in intensity. It is important to note that kidney pain can be caused by many different medical problems, so diagnosis and treatment may vary. Below are some forms of kidney pain:

1. Acute kidney pain:

   • Acute pain in the kidneys can be caused, for example, by renal colic, which is often associated with the presence of stones in the urinary tract. This pain can be sharp, breaking and severe. Patients with renal colic often feel excruciating pain in the lower back or side of the abdomen, which can spread to the abdomen and groin.

2. Dull or simple pain:

   • Dull or softer pain in the kidneys may be due to chronic conditions such as chronic kidney disease. This pain may be longer lasting and less intense, but still requires the attention of a medical professional.

3. Feeling of pressure or distension:

   • Patients may describe a feeling of pressure or distension in the renal area, which may be accompanied by discomfort or pain.

4. Localized pain:

   • The pain may be localized to the area of one or both kidneys, and it may change with movement or body position.

5. Lower back pain:

   • Kidney pain may also present as pain in the lower back, closer to the pelvis.

6. Radiating pain:

   • Sometimes pain from the kidneys can spread through the urinary tract and cause radiating pain to the lower abdomen, inner thigh, or groin area.

7. Pain when urinating:

   • Kidney pain may also be accompanied by pain when urinating, which may be a sign of a urinary tract infection.

Diagnostics kidney pain

Diagnosis of kidney pain requires a comprehensive approach and may include the following methods and procedures:

1. Medical history and interview: Your doctor will begin collecting information about your medical history, including your pain symptoms, intensity, duration, nature, and factors that might make your symptoms worse or better.

2. Physical examination: The doctor performs a physical examination to check the condition of the kidney area and other organs. He or she may palpate (feel) the kidneys and abdomen.

3. Laboratory tests:

   • A complete urinalysis (CUA) helps determine the presence of blood, protein, and other abnormalities in the urine.
   • A blood test to measure creatinine and urea levels can be used to assess kidney function.
   • Blood electrolyte levels may be measured to determine if there are any electrolyte imbalances.

4. Instrumental methods:

   • A kidney ultrasound (ultrasound) can visualize the kidneys and determine the presence of stones, tumors, or other abnormalities.
   • Computed tomography (CT) scans may be used to visualize kidney structures in more detail and identify causes of pain, such as stones or tumors.
   • Magnetic resonance imaging (MRI) may also be used to look at the kidneys and surrounding organs in more detail.

5. X-rays: Sometimes an X-ray of the urinary tract with contrast material (retrograde pyelography) may be needed to look for problems with the urinary tract.

6. Cystoscopy: This procedure allows your doctor to look at your urinary tract and bladder using a special camera.

7. Other tests: In some cases, additional tests, such as a scintigraphy scan or a kidney biopsy, may be needed to confirm the diagnosis.

Differential diagnosis

Distinguishing lower back (back) pain from kidney pain can be difficult because the lower back area is close to the kidneys and the pain sensations can be intertwined. However, there are a few signs that can help you figure out where the pain is coming from:

1. Localization of pain:

• Back (lumbar region): If the pain is mainly concentrated in the lumbar region and feels like a sharp or dull ache in the back, it may indicate back problems such as a herniated disc, muscle strains or osteochondrosis.

• Kidneys: Kidney pain may radiate from the side of the lower back down to the abdomen. Sometimes it may be accompanied by a feeling of heaviness or pressure in the lumbar region.

2. Nature of pain:

• Back (low back): Back pain can be associated with a variety of characteristics, including sharp, stabbing, dull, or aching. This pain may be aggravated by movement, weight bearing, or certain body positions.

• Kidneys: Kidney pain is usually described as painful, less often as sharp. It may be accompanied by other symptoms such as frequent urination, pain when urinating, blood in the urine or swelling.

3. Associated symptoms:

• Back (low back): Back problems may cause symptoms such as limited range of motion, muscle weakness, numbness or tingling in the legs.

• Kidneys: If kidney problems cause pain, they may be accompanied by urinary tract symptoms, including fatigue, nausea, and vomiting.

Treatment kidney pain

Treatment for kidney pain depends on the underlying cause of the pain. If you have severe kidney pain, see your doctor for diagnosis and to determine the underlying condition. Below are common treatments that may be used for kidney pain:

1. Treating the underlying cause: The first priority is to treat the underlying disease or condition that is causing your kidney pain. For example, a kidney infection may require antibiotics, kidney stone pain may require stone removal, and inflammatory conditions may require anti-inflammatory medications.
2. Pain medications: Medications such as analgesics or anti-inflammatory drugs may be used to relieve pain and discomfort. However, their use should be under the advice of a physician.
3. Drink plenty of fluids: When you have kidney stone pain, it is important to drink enough fluids to help remove stones from the urinary tract.
4. Rest and routine: In some cases, rest and limiting physical activity may help manage kidney pain.
5. Avoiding Irritants: If your kidney pain is caused by certain foods or medications, you should avoid consuming them.
6. Proper Diet: For certain conditions, such as kidney stones, it is recommended to follow a certain diet that can help prevent new stones from forming.
7. Physical therapy: In some cases, physical therapy may be helpful in reducing pain and inflammation.

What should you not eat if you have kidney pain?

If you have kidney pain or other kidney health issues, it is important to watch your diet and avoid certain foods and drinks that may negatively affect your kidneys or worsen your symptoms. Below is a list of foods and substances that are best to limit or avoid if you have kidney pain:

1. Salty foods: Too much salt (sodium) in your diet can increase blood pressure and negatively affect kidney function. Limit your salt intake.
2. High-protein foods: Snacks, meats, and fish with high protein content can increase the burden on the kidneys. Moderate protein intake and avoiding overeating are recommended.
3. Carbonated drinks: Drinks high in sugar, especially carbonated drinks, may increase the risk of obesity and diabetes, which can put extra pressure on the kidneys.
4. Foods High in Phosphorus: High intakes of phosphorus, such as those found in some soft drinks and processed foods, can be hard on the kidneys.
5. Caffeine: Avoid excessive consumption of coffee and caffeinated beverages as they may increase blood pressure and have a diuretic effect.
6. Alcohol: Moderate alcohol consumption may be allowed, but avoid excessive consumption as alcohol can negatively affect kidney function.
7. Fatty and fried foods: Foods high in saturated fats and trans fats can contribute to heart disease and increase the risk of kidney damage.
8. Unprescribed medications: Avoid self-medication with medications without consulting a doctor, as some medications may adversely affect kidney health.
9. Sugary foods: Limit your intake of foods high in sugar, as sugar can contribute to obesity and diabetes.

It is important to note that the diet should be tailored to your specific condition and your doctor’s recommendations. If you have kidney problems or kidney pain, you should consult with your doctor or nutritionist before making any dietary changes or taking supplements.