Kidney Pain : Causes, Types, Treatment and Symptoms

Kidney pain, which can range from a dull ache to a sharp pain, is felt in the flank area and is often mistaken for common back pain because of the kidneys’ proximity to back muscles.

Most common Kidney Pain symptoms:

• Swelling in the legs, ankles, or feet
• General malaise, tiredness, nausea, vomiting, fevers and chills
• Pin or burning sensation during urination
• Frequent urination with an urgent need to urinate
• Pink, red or brown-colored urine indicates the presence of blood.
• Cloudy, dark, or foul-smelling urine
• Gravel-like material in the urine
• The person may also experience loss of appetite, confusion or a foggy feeling.

Common, Uncommon or Underlying Causes of Kidney Pain

Kidney pain can have a variety of common, rare, and underlying causes, including infections, physical trauma, genetic disorders, and certain medications. Other parts of the urinary system or even nearby organs may occasionally be the source of the pain rather than the kidneys themselves.

• Kidney stones – Hard mineral deposits produce intense, severe pain when they pass from the kidney to the urinary tract.
• Kidney infection (Pyelonephritis) – As germs migrate from the bladder to the kidneys, they cause persistent or severe discomfort in the back and side, as well as fever and chills.
• Kidney injury – Physical damage from accidents or sports can produce pain ranging from mild to severe, depending on the severity of the injury.
• Polycystic kidney disease (PKD) – Fluid-filled cysts enlarge the kidneys, causing back or side pain and potentially leading to infections and renal failure.
• Hydronephrosis – A condition where a kidney swells due to a blockage, and the resulting urine backup causes pressure and pain.
• Renal vein thrombosis – A blood clot in the main renal veins is a rare illness that can produce severe, constant back or side pain.
• Renal artery stenosis – The constriction of the kidney’s blood supply artery can cause high blood pressure and renal discomfort.
• Glomerulonephritis – The constriction of the kidney’s blood supply artery can cause high blood pressure and renal discomfort, leading to kidney pain.
• Atheroembolic renal disease – A condition where a cholesterol plaque from a big artery travels to the kidneys, clogging minor arteries and causing pain and discomfort.
• Kidney pain associated with underlying medical conditions – It includes Alport syndrome (a rare genetic disease), lupus (an autoimmune disorder), diabetes, high blood pressure, and certain medications.

When to Seek a Specialist for Your Kidney Pain?

For severe, ongoing, or accompanied kidney pain, consult a specialist such as a nephrologist or urologist, who can offer a conclusive diagnosis following an initial assessment by a primary care physician.

• Signs of dehydration
• Sudden and unexplained swelling in the extremities (hands, feet or ankles)
• Severe pain in the back, side, or abdomen
• Inability to urinate or very little urine output
• Inability to retain fluids in the body, associated with high fever and chills
• Constant and excruciating pain, making it difficult to find a comfortable position

Visit a nephrologist if you notice:

• Abnormally high blood pressure
• Electrolyte imbalance
• Recurring kidney stones
• Chronic kidney disease (CKD)

Don’t wait for signs to grow severe. Consult our kidney specialists today

Diagnostic Approach for Kidney Pain

To diagnose the cause of kidney pain, healthcare providers use a medical history, physical exam, and various tests to differentiate it from other pain sources and pinpoint specific issues like infections or kidney stones.

• Medical history and physical examination: When diagnosing kidney pain, a doctor will evaluate your medical history, inquire about the pain’s features and concomitant symptoms such as fever or urinary difficulties, and perform a physical examination to confirm tenderness over the kidneys and determine the source of the pain.
• Urinalysis: uses a dipstick and a microscope to look for evidence of kidney illnesses, like bacteria or kidney stones, like crystals and blood.
• Urine culture: If a urinalysis indicates an infection, a urine culture may be done to determine the exact bacteria causing it.
• Serum creatinine and estimated glomerular filtration rate (eGFR): These tests can suggest impaired kidney function because these tests assess how successfully the kidneys filter the waste product creatinine from the blood.
• Blood urea nitrogen (BUN) test: High amounts of urea nitrogen, a waste product filtered by healthy kidneys, may indicate poor kidney function.
• 24-hour urine collection: This test examines urine volume and composition, which can help uncover metabolic causes of recurring kidney stones, such as high calcium or uric acid.
• Complete blood count (CBC): It detects symptoms of infection, such as high white blood cells, or anemia, which is characterized by low red blood cells and is common in chronic renal disease.
• Kidney biopsy: performed to collect a tiny tissue sample and evaluate the specific type of kidney injury, in case of severe or unexplained kidney illness.
• Genetic testing: It may be required for rare genetic disorders such as Polycystic Kidney Disease (PKD) or cystinuria.
• Non-contrast CT is the most accurate imaging test for identifying kidney stones, while a renal ultrasound is an excellent first step. Other modalities, such as X-rays and MRI, are used for monitoring or in particular instances, such as pregnancy.

Types of Kidney Pain

Kidney pain is classified according to its underlying cause, which allows clinicians to distinguish it from other illnesses and select the best treatment.

• Acute kidney pain: sudden and typically severe pain from a kidney stone or an acute infection.
• Chronic kidney pain: the pain is persistent and dull, often related to CKD or PKD.
• Pain from injury: the pain ranges from mild to severe, depending on the extent of the physical trauma to the kidneys.
• Referred pain: pain originating from the kidneys felt in other areas of the body, such as the abdomen, groin, inner thigh, testicles or labia.
• Pain while urinating: a burning or stinging feeling while urination can be identified as a UTI; if they are accompanied by fever and flank pain, it may indicate the kidneys are also involved.
• Pain with physical activity: Although kidney stone pain can occur in waves and be caused by movement when the stone shifts, it usually does not fluctuate with movement like back pain does.
• Persistent dull pain: pain in the back, flank, or side can indicate a more chronic or systemic issue.
• Renal colic or severe, sharp, or stabbing pain: a characteristic of kidney stones may come in waves, and radiates to different areas of the body.
• Flank pain: Pain on one or both sides of the spine, between the ribs and hips, frequently caused by a kidney infection, tumor, or edema.

How to Treat Kidney Pain Symptoms?

Treatment for kidney discomfort involves a proper diagnosis from a healthcare expert to discover the underlying reason, but a few at-home treatments and surgical approaches can help control the symptoms.

For underlying causes, treatments & management strategies include:

• Avoid irritants such as alcohol or caffeinated drinks.
• Avoid strenuous activities, heavy lifting, and get some rest.
• Apply a heating pad or a hot water bottle to soothe discomfort and relax strained muscles.
• For small kidney stones, you can try drinking plenty of water to flush them out, but it is crucial to consult your specialist beforehand.
• For large kidney stones:
  – Shock wave lithotripsy (SWL) – uses sound waves to break down the stones.
  – Ureteroscopy – insertion of a thin lighted tube through the urethra.
  – Percutaneous nephrolithotomy (PCNL) – a minimally invasive surgery, removes the stones directly through surgery.
• For large kidney infections, the surgeon may provide a personalized antibiotic course based on the severity of the infection and the type of bacteria identified.
• For PKD, keeping the blood pressure in check, taking over-the-counter pain relievers, or draining the cyst via surgery.

What if Kidney Pain is Left Untreated?

Since the kidneys are essential for controlling blood pressure and filtering waste, ignoring kidney pain can have serious consequences. The dangers vary depending on the underlying cause, so make sure you book an appointment with your specialist.

Some possible complications of an untreated Kidney Pain include:

1. In untreated kidney infections:
   – Permanent kidney damage or scarring
   – Formation of abscesses in the kidney
   – Urosepsis – a life-threatening inflammatory response occurs if the infection enters the bloodstream.
2. Untreated kidney stones:
   – Urinary tract obstruction -> bacterial multiplication -> pressure builds up in the kidneys -> swelling of the kidneys (hydronephrosis) -> severe infection -> sepsis formation -> permanent kidney damage.
3. Untreated chronic conditions: CKD, high blood pressure, electrolyte imbalance, fluid retention, worsening of PKD

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