Kidney Pain

Location of Kidneys in our Body

As per the anatomy of our body, organs are situated on either side of the spine just under the lower ribs in, the lower back (Image 1). They are located deep inside the upper abdomen, below the diaphragm facing the muscles in the back.

The pain in the kidneys usually felt at the spots where they are situated: on the sides of the spine, below the rib cage, at the center of the back.

Kidney Specific Medical Names:

• Renal = In context with kidneys
• Renal colic = Instant, extreme pain in kidney
• Hematuria = Urinating blood

Where is Kidney Pain Felt?

• Kidney pain is usually felt below the lower ribs in the middle back of the spine on each side where organs are located and at times, in the hips (loin or flank pain)
• On both sides or one side of the upper abdomen
• Groin pain because of kidney stones in the ureter

Kidney Pain vs. Various Other Reasons for Lower Back Pain

1. Normally, pain in the kidney not directly connected with the positioning of the body, or workouts, whereas the muscle, bone, joint or never pain are.
2. The basic difference between kidney pain and other lower back pain is the fact that kidney pain triggers symptoms such as nausea, constant urination, and cloudy urine.

Signs and Symptoms of Kidney Disease

Because of the fact that kidney pain isn’t precise or indicative, it often misjudged with side pain resulting from the liver, spleen colon, pancreas, lungs, abdominal (an aneurysm) or pain in the lower back originated from the spinal nerves, muscles or spine.

Signs and symptoms that can verify the source of the kidney pain are as follows:

• Foamy or cloudy urine or urinating blood
  Constant urination
• Vomiting, fever, anorexia, chills, nausea.
• Softness in the flank(s)
• Occurrence of a lump in the upper abdomen or flank(s)
• Slight pain felt when lightly punched on the body where the kidneys are located using the fist
• Edema (swelling in the body)

The majority of these scenarios mentioned below can occur in kids as well as adults.

Instant (Severe), Extreme Pain in the Kidney or Renal Colic

Pain Due to Kidney Stones

Kidney stones are painless, however, these stones when get stuck inside the ureter and block the flow of urine, they become painful and could result showing the following signs regularly starting in the night or early in the morning:

• Within just 30 minutes to couple of hours, you can feel slight pain the left or right flank that becomes frequent and extreme and would remain for long hours ranging somewhere between one to four hours to more than twelve hours; the pain can also spread to the lower abdomen, groin, genitalia (vulva, testicles), or inner side of the thighs. (Image 2). Basically, the pain appears as instant but irregular cramps (colic pain) or spasms lasting within the range of 5 minutes to an hour long.
• Urinating blood (red or pink urine) and, ultimately, passing 1 or many stones while urinating.
• Vomiting, nausea, or dry heaving
• Fever isn’t a general symptom resulting from non-infected simple kidney stones.

Kidney stone pain

Kidney pain occurring because of kidney stone can originate in the lower abdomen, genitalia, and flank.

Impediment of the Ureteropelvic Junction (UPJ)

The difficulty of the upper part of the ureter resulting from surgery, infection or congenital disorders, generally found in children, is known as obstruction of the Ureteropelvic Junction (UPJ) or pelvic-ureteric junction (PUJ).

Key characteristics:

• Rare instant pain felt in the flank, typically before consuming massive quantity of fluid such as caffeinated drinks, alcohol, or just after taking diuretics
• Occasional formation of a blatant mass in the upper abdomen resulting from dilated kidney (hydronephrosis) and urinating blood

Loin Pain Hematuria Syndrome (LPHS)

A rare state resulting from hormonal changes, using oral contraceptives, or infection, especially in younger women, is known as Loin Pain Hematuria Syndrome (LPHS).

Signs of LPHS are as follows:

• Constant or regular extreme, blazing or hammering pain in the loin on both sides or any one, infuriated by movements or workouts
• Nausea, occasionally urinating blood or fever
• The symptoms can last for a few hours or could stay long for months, years or even for the whole life

Other Reasons for Instant Pain in Kidney

• Acute hydronephrosis– enlargement of the kidney resulting from the back flow of the urine basically because of the blocked ureteral stone
• Formation of blood clots inside the ureter caused by an injury in the kidney, sickle cell anemia or hemophilia, in kidney tumors
• Renal papillary necrosis is the damage of kidney tissue arising from liver cirrhosis, mismanaged diabetes, or continuing analgesic abuse, generally in women

Pounding Kidney Pain

Pounding, animated kidney pain can spread through the back in upward or downward direction and remain either for a few seconds or stays for minutes.

IgA Nephropathy (Berger’s disease)

IgA nephropathy is one of the different conditions of kidney inflammation (glomerulonephritis). Signs can occur within 3 days resulting from a gastrointestinal or respiratory infection and could remain for 3 days:

• Slight cramp or spasms in both the flanks
• Tea-or-cola or brown colored urine

Other Reasons for Pounding Kidney Pain

• Lodging the flow of the urine resulting from strictures (scars), ureteropelvic junction (UPJ) obstruction prior to surgery in the abdomen, or occurrence of stones inside the ureter
• Loin pain hematuria syndrome (LPHS) (12)

Mild Kidney Pain

Kidney Infection (Pyelonephritis)

Women are more prone to contracting infections in the kidney than men. The signs of such infection can occur instantly within couple of hours or could take days. They are as follows:

• Dull, mild pain, distress and softness in the right, left or both the flanks
  Vomiting, nausea
• Chills and severe fever
• Stinky and foamy urine or urinating blood
• Diarrhea, stiff neck, lack of appetite
• Signs of urethra (urethritis) infection or bladder (cystitis) infection are constant urination, throbbing pain while urinating, urge to urinate

Polycystic Kidney Disease

A genetic condition causing several cysts in both the kidneys is referred to as polycystic kidney disease. Signs and symptoms of this disease are as follows:

• Cloudy urine or bloody urine
• Constant UTI (urinary tract infections)
• High blood pressure
• Upper abdomen pain or middle back pain, a palpable lump with swelling on two sides of the upper abdomen

Other Reasons for Mild Kidney Pain

• A complication occurring due to systemic or urinary tract infection results in a contained accumulation of pus in kidney is called renal abscess; it results in a blatant mass in the loin, chills and fever.
• Fungal bezoars can occur before organ transplantation, due to diabetes or take continuous antibiotic treatment.
• IgA nephropathy (Berger’s disease)
• Urethral strictures (scars) before ureteroscopy, obstruction of the urinary track, kidney stones, kidney surgery or radiation, can develop chronic hydronephrosis
• Cyst in kidneys, cancer or tumor can develop pain in the flank and rare blood in the urine.
• An irregular development of scar tissue around the kidney area without any valid cause is known as retroperitoneal fibrosis. Signs: flank pain, lower abdominal pain, pain in the buttocks, scrotum, or buttocks.

Bilateral Kidney Pain (in Both Flanks)

A condition or disorder that results in kidney pain on two sides simultaneously:

Kidney Inflammation

There are two basic kidney inflammation types. They are interstitial nephritis and glomerulonephritis. The reasons of such inflammation are a bacterial infection in the throat, side effects from medicines, as well as autoimmune disorders like systemic lupus erythematosus (SLE).

Signs of Kidney Inflammation are as follows:

• Feeling pain in both or either one the flanks
• Urinating blood
• Swelling of the eyes, of the feet or overall swelling in the body
• Cloudy urine

Other Reasons for Kidney Pain on Two Sides

• Loin pain hematuria syndrome (LPHS)
• Polycystic kidney disease
• Kidney infection (pyelonephritis)
• Nephrocalcinosis–increase in calcium inside the kidney tissue in different congenital disorders like primary hyperoxaluria and medullary sponge kidney, etc.; signs are similar as found with kidney stones
• Bilateral hydronephrosis–expanded kidneys on two sides developing lumps on two sides of the upper abdomen; reasons: ureteropelvic junction (UPJ) obstruction, neurogenic bladder (prior to spinal cord injuries), vesicoureteral reflux (rearward passage of urine into ureter from the bladder)
• Renal vasculitis– developing inflammation of the blood vessels in the kidneys
• inflammation of the blood vessels in the kidneys–, found specifically during Henoch-Schönlein purpura, polyarteritis nodosa, Wegener’s granulomatosis, essential mixed cryoglobulinemia, microscopic polyangiitis; signs: mild low-grade fever, skin rash
• Other (6):
  • Haff disease prior to consuming Buffalo fish
  • Ethylene glycol poisoning (ingestion)
  • Anaphylactic reaction (extreme reaction from allergy)
  • Serious injury in the muscle or compression in the limbs (frequent for chronic alcoholics) can result in muscle breakdown and other reasons causing heavy myoglobin excretion during urination (myoglobinuria)
  • X-ray contrast toxicity
  • Sickle cell anemia and other reasons for blood hemolysis like transfusion reaction and serum sickness

Kidney Pain Post Drinking

During urinary tract obstruction, the back pressure from urine can develop kidney pain in couple of hours after consuming huge quantity of liquid food or prior to consuming diuretic; common reasons are:

• Neurogenic bladder
• Pregnancy
• Kidney stone stuck inside the ureter
• Ureteropelvic junction (UPJ) obstruction
• Bladder can cause bladder outlet barrier
• Development of a blood clot in the urinary tract resulting from bleeding due to kidney cancer or injury

Does Kidney Failure Pain?

Chronic or acute kidney failure isn’t painful. Kidney failure results from an extreme damage with the kidney functioning. However, there is no harmful physical damage in the initial stage, and hence there’s no pain. Signs of kidney collapse are an irregularity in urination, nausea, fatigue, itchy and pale skin, and accidental weight loss, lack of breath, swollen hands and ankle. Extreme kidney failure can develop pain in the flank(s).

Differential Diagnosis:

General disorders causing similar agony as kidney pain are:

• Rheumatoid arthritis
• Gallbladder dyskinesia
• Stretched muscle (see Kidney pain vs. lower back pain)
• Rib fracture
• Sciatica due to herniated disc in the lumbar spine
• Pneumonia or inflammation of the lung membranes (pleurisy)
• Myofascial pain
• Shingles
• Inflammation of the abdominal membrane (peritonitis)
• Liver inflammation (hepatitis)
• Acute pancreatitis
• Abdominal bloating (splenic flexure syndrome)
• Enlarged spleen
• Contusion
• Serratus anterior muscle pain syndrome
• Gallstones, Acute cholecystitis or other cause of gallbladder pain
• Endometriosis
• Ankylosing spondylitis
• Sphincter of Oddi dysfunction
• Adhesions
• Vertebral fracture