Kidney Pain: Causes and Treatment in NYC (Brooklyn, Manhattan, Queens, LI, SI)
Experienced urologists at New York Urology Specialists have extensive expertise in treating men and women with kidney pain. We see patients who live and work in Manhattan as well as from Brooklyn, Staten Island, Long Island, Westchester, from Bergen county NJ and Nassau County. Dr. Alex Shteynshlyuger is an experienced urologist.
Common Causes of Kidney and Flank Pain
There are many causes of renal pain. Some of these are fairly common such as kidney stones and others are rather rare such as renal infarcts. They are listed based on frequency, from most common to least common causes.
- Kidney stones
- Uretero-Pelvic Junction (UPJ) obstruction
- Kidney tumours
- Hematuria and blood clots
- Papillary necrosis
- Polycystic kidney disease
- Renal and perinephric abscess
- Retroperitoneal fibrosis
- Acute renal infarction
- Renal vein thrombosis
Evaluation of kidney and back pain.
patient history, physical exam can provide valuable clues to the cause of back pain. Ultrasound of the kidneys, MRI of the abdomen or a CT scan of the abdomen may be used to further elucidate the cause of back and kidney pain
Blood work including creatinine can help to confirm that the kidneys are working normally.
Treatment of kidney and flank pain.
Effective treatment options are available for men and women with renal pain. Evaluation typically includes a physical exam, blood and urine tests, kidney ultrasound or CT scan.
Once the cause of pain established, the treatment approach is guided by the underlying diagnosis. For example if a kidney stone or ureteral stone is discovered the treatment would involve breaking and removing the stone from the kidney or the ureter.
- Renal pain can be dull and vague or acute and sharp depending on the cause.
- Kidney stones are an important cause of recurrent renal pain. The pain is usually sharp, spasmodic and can come and go.
- Pyelonephritis refers to inflammation of kidneys. It is usually caused by bacterial infection. It presents with fever, rapid pulse rate as well as flank or back pain.
- Renal and peri-renal abscess is caused by blood borne infection or ascending infection along the ureters. In addition to pain it can also present with fever, chills, nausea, vomiting, abdominal pain and dysuria.
- Blood clots sometimes block renal pelvis or the ureter resulting in pain or clot colic. This may occur in association with kidney stones or a tumour.
- Papillary necrosis occurs due to lack of blood supply to kidney and can result in severe pain. It is more common in diabetics but can be caused by medications, sickness and a number of other causes. Necrotic papilla can obstruct renal calyces, uretero-pelvic junction (UPJ), ureter or uretero-vesical junction. Infection and stone formation may also occur. All these complication may result in renal pain. People with diabetes mellitus are at high risk of developing papillary necrosis.
- Kidney tumors are usually slow growing but highly vascular. They can cause vague dull discomfort and less commonly sharp pain. The classic presentation is flank pain, blood in urine and flank mass.
- Ureteropelvic Junction – UPJ obstruction is a functional obstruction of the upper end of ureter. This condition may occur on one or both sides. It usually presents with dull aching pain aggravated by fluid intake or alcohol. Dilatation of renal pelvis occurs and is called hydronephrosis. Pain occurs due to stretching of renal capsule. This condition may be intermittent as seen in Dietl’s crisis; loin swelling occurs due to hydronephrosis along with acute pain which subsides after some time with disappearance of swelling and passage of a large volume of urine.
- Retroperitoneal fibrosis is characterised by extensive fibrosis in the region of kidneys and ureters. Its cause may be related to auto-immunity, drugs, infections or certain cancers. Fibrosis causes ureteral obstruction resulting in backpressure changes in the kidneys including kidney pain. Renal failure may occur.
- Acute renal infarction occurs due to sudden obstruction of renal artery or its branches. It presents with persistent flank pain, nausea and vomiting. Segmental renal infarcts may occur and are associated with pain and development of hypertension.
- Renal vein thrombosis may occur in hypercoagulable state in which spontaneous clotting of blood occurs in the veins. It is commonly associated with loss of proteins in urine, renal pain and leg swelling. Renal vein thrombosis may also occur in renal cancer and after kidney transplantation.
- Glomerulonephritis is an immune-mediated inflammatory condition that results in progressive deterioration of kidney function. Damage to the filtering units called glomeruli results in loss of blood and proteins in urine. Flank pain and hematuria are common presenting features.
- Polycystic kidney disease results due to formation of multiple cysts in both kidneys resulting in kidney enlargement. These cysts are filled with clear or blood stained urine and can get infected and cause pain.
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