Kidney Pain Emergencies

Kidneys are bean-shaped organs about the size of a fist. They filter waste out of the blood and produce urine to remove that waste along with the extra fluid from the body. The kidneys are located toward the back and underneath the rib cage, which is why back pain can be confused with pain from an infection or disease of the kidneys, such as kidney stones, urinary tract infections, etc. Since there are muscles, bones and other organs around the kidney, it may be tricky to pinpoint where the pain is really coming from. It is important to tell where the pain is coming from to get the right treatment.

What is the difference between back pain and kidney pain?

Here are the things you can watch out for to tell if you have back pain or you’re having kidney pain:

1. What part of the back hurts?
   
   When the pain radiates from the flank, the lower part of the ribcage, there is a chance that it may be a kidney stone. Pain from other parts of your back is probably back pain.


2. How intense is the pain?
   
   Back pain is usually tolerable, but it still depends on how much stress or damage your ligaments, muscles, tendons or discs went through. Pain caused by kidney stones is usually a sharp pain, like being stabbed, or a dull pain if it is from a kidney infection. The pain also depends on the severity of the infection or the size of the kidney stone.


3. How long have you been experiencing pain?
   
   Most acute cases of back pain usually resolves on its own within days rather than weeks. Nonsteroidal anti-inflammatory medications (NSAIDs) usually relieve back pain. Severe kidney pain usually does not go away with the NSAIDs, and nothing will relieve the pain unless the problem is addressed. If the pain persists, consult your doctor for proper diagnosis and treatment.

Three Kidney Pain Emergencies

The most common kidney problems that cause kidney pain include the following:

1. Kidney Stones

This is the most common type of kidney problem that causes kidney pain, and one of the most painful. Kidney stones are masses made of crystals that usually originate in the kidneys, but can also develop anywhere within the urinary tract. The urinary tract consists of the kidneys, ureters, bladder and urethra. Kidney stones sizes range from a grain of sand to a golf ball. In general, as the stone gets bigger, the more noticeable the symptoms are. Small kidney stones are passed without you even knowing it. When the stone gets bigger and it blocks the urinary tract, you may have pain in the flank, an intense need to urinate, a burning sensation when urinating and cloudy/bloody or smelly urine, which are the most common symptoms of kidney stones.

2. Urinary Tract Infections

Most urinary tract infections (UTIs) occur in the upper tract which consists of the ureters and kidneys. Infection happens when bacteria from the skin or rectum enter the upper tract. Bacteria settles and multiplies in the urinary tract which causes inflammation and swelling. Women have higher risk of getting UTIs because their urethras are shorter and closer to the rectum. The symptoms of UTIs are almost the same with those of kidney stones accompanied with high or very low temperature.

3. Acute Kidney Injury

Acute kidney injury (AKI) is a sudden episode which ranges from minor loss of kidney function to total kidney failure. This causes the buildup of waste products in the blood which might also affect other organs such as the brain, heart and lungs. AKI requires immediate treatment, and it is essential to be detected early. Symptoms of AKI include peeing less than usual, confusion, nausea, chest pain, swelling in legs, ankles and around the eyes and in severe cases, seizures or coma.

Causes and Risk Factors

In general, the causes among these common kidney problems are the same, which are mainly:

• Dehydration
• Diet with excessive sodium
• Obesity
• Family history (diabetes, hypertension, etc.)
• Prior medical conditions and previous surgeries

However, UTIs have very specific risk factors:

• Being a woman (especially when the woman has gone through menopause)
• Being sexually active
• Having a catheter
• Having a diaphragm or use of spermicides for birth control

Most AKIs also occur as a complication from another serious illness (chronic kidney disease, enlarged prostate, pelvis/bladder tumor, etc.) or severe infection such as sepsis.

Diagnosis & Treatment

Kidney diseases sometimes have no symptoms. In fact, more than 37 million Americans (1 in 7 adults) have kidney disease. Millions more have increased risk of getting it and most don’t know it. Kidney conditions are another reason to continue to have an annual check-up with your doctor. If he or she suspects kidney problems, you may be advised to undergo some tests:

• Blood test: eGFR
• Computed tomography (CT) scan
• Urine test
• Kidney biopsy
• X-ray

Drinking lots of water is the first thing your doctor might recommend if you experience mild symptoms. The doctor might also recommend antibiotics and minimally invasive treatments for kidney stones and UTIs. In the case of AKIs, you might have to stay in the hospital to further treat the prior conditions that led to AKI.

Sources:
American Chiropractic Association
National Kidney Foundation
American Kidney Fund
Healthdirect
Nursing Times
National Kidney Federation
National Health Service
Office on Women’s Health
Healthline