I'm Dr. Frita, I am a board-certified nephrologist, which means I am a kidney disease specialist. Kidney pain is something I deal with in my practice day in and day out and there are so many types, whether it's flank pain, abdominal pain, or pain when you urinate. And depending on the kidney pain symptoms and causes, it can really be a hint to an underlying kidney disease that you may have. So it's really important to recognize what these symptoms mean and what's going on because if you ignore them, it could potentially lead to you having chronic kidney disease or even kidney failure. So today, we are going to talk about it, and I'm going to give you the top causes and symptoms of kidney pain that you should never ignore!
Top Kidney Pain Symptoms and Causes
As mentioned, in my practice, many patients come to me complaining of pain in their kidneys, and they have various symptoms that are just huge hints and warning signs, of underlying kidney disease. What I would like to do in this article is empower you, so that if you're having kidney discomfort or certain symptoms, you can have a good idea of what is serious, what is not, and when to call your doctor.
You definitely don't want to ignore some of these symptoms, as they may indicate an underlying cause of the symptoms that could potentially lead to kidney failure. So let's dive in!
1. Kidney Stones or Nephrolithiasis
Kidney stones, or nephrolithiasis, can definitely cause kidney pain. I'm telling you right now, kidney stones will make my grown male patients cry and fall to their knees. It's no joke. Now, when you get pain from kidney stones, it can present as flank pain which is a pain in your lower back, usually under the ribs but above the hips, and it can be on one side or both, and it's where the love handles are.
Pain from kidney stones can also cause generalized abdominal pain, meaning more in the front, like where you consider your stomach to be. You can also get side pain. Pain from kidney stones can also radiate, meaning it can start off in one place, like in your flank or where your kidneys are, and then it can shoot or radiate or go toward another area, like in the groin.
When it comes to kidney stones, depending on the location, you may have some pain that radiates, not only to the groin but, with kidney stone pain in men, it can radiate to the testicle. If you have a kidney stone that is down in the ureter, which is that tube that connects the kidneys to the bladder, then it can radiate to your testicle on the same side.
Kidney stone pain in women can radiate to your labia or to your lip in the genitalia. The kidney stone pain can be for different reasons. It can be because the kidney stone is actually blocking urine flow. If it does that, it causes an obstructive nephropathy that can cause the kidney to swell and cause pain for that reason.
You can also get something called renal colic, which is when the kidney stone moves. The way the kidneys work, we have a peristalsis, meaning we have waves of movement in our kidney system. Well, if the wave causes tightness around that kidney stone, it can cause you to have renal colic or pain that could last for up to 20 minutes, like a 10 out of 10 pain. But then as peristalsis continues and the tightening loosens up around the stone, the pain can subside. So you can get renal colic, or the pain can come from the kidney stone literally scraping the inside of the kidneys.
2. Urinary Tract Infections
Urinary tract infections, or UTIs, are another cause of pain in the kidney area. Urinary tract infections are a very common infection, usually caused by bacteria, but you can also get fungal urinary tract infections as well. Women are four times as likely to get UTIs as Men, and this is why. The way that the bacteria will climb up and get into that urinary tract system or get into the urethra and the bladder, they have to climb through a tube.
The kidney system functions in the following way: the bladder holds urine, and the tube that connects the bladder to the external environment is known as the urethra. With women, the urethra is very short, whereas, with men, the urethra has to go from the bladder all the way through their organ so it tends to be longer. Because women have a short urethra, it's not very hard for these bacteria to climb their little sticky mean selves up and get into the bladder and cause an infection, a bladder infection, or cystitis.
Urinary Tract Infection (UTI) Pain Symptoms
So let's talk about some of the pain symptoms associated with a urinary tract infection or UTI.
- Abdominal Pain - You can get the abdominal pain that we talked about earlier. Oftentimes it's going to be in the lower abdomen if you have a bladder infection or cystitis.
- Dysuria - Dysuria refers to the pain experienced during urination. It can be a symptom of pain associated with urinary tract infections (UTIs).
- Hematuria or Blood in the Urine - A UTI can cause blood in the urine and it can look bright red, or more often than not, it may look pink or like little spots of blood in the urine. This can be a symptom associated with a urinary tract infection.
- Honeymoon Cystitis - With UTIs, there's something that is called honeymoon cystitis. So what does that mean? Honeymoon cystitis is a term used to describe the frequent occurrence of urinary tract infections (UTIs) during or after sexual intercourse.
One way to prevent UTIs, for ladies in particular, is after you have sexual intercourse and when all of that bacteria is just kind of there waiting to crawl up your short little urethra. Well, as soon as you finish having intercourse, it's best if you hop up and you urinate. Yes, you urinate. By urinating promptly, you can minimize the risk of bacteria, such as E. coli or Klebsiella, climbing up your urethra and causing a urinary tract infection (UTI). This proactive approach reduces their opportunity to thrive and safeguards your well-being. Just a little advice.
3. Kidney Infection or Pyelonephritis
We previously discussed how bacteria can travel up the urethra and cause a urinary tract infection. However, if this infection continues to ascend through the ureters (the tubes that connect to the kidneys), it can result in a kidney infection known as pyelonephritis. Kidney infections can cause severe kidney pain.
Kidney infection symptoms that you typically get with pyelonephritis include:
- Back Pain - You may experience discomfort in your upper back or experience the flank pain, as we discussed earlier. This pain can be located in the area where your love handles are. You can also experience side or abdominal pain.
- Pyelonephritis - With pyelonephritis, you can even get sepsis or an overwhelming infection in your body that could even lead to septic shock. And certainly, again, with pyelonephritis, you can still have dysuria, hematuria, and you can have cloudy urine.
- Urinary Frequency - Another thing with these urinary tract infections is that you can get urinary frequency. What does that mean? You have to get up and use the restroom. A lot of times, you feel like you are frequently having to run and use the restroom, that's urinary frequency.
- Urinary Urgency - This is when you feel like you have to go to the restroom, "gotta go, gotta go, gotta go right now", but once you get there, you realize really that you didn't have to go.
So if you're having any of these symptoms, please be aware. It could be a sign that you have a urinary tract infection that may have even progressed to a kidney infection or pyelonephritis. Oh, and if you do get that sepsis or that overwhelming infection with UTIs, bladder infection, or pyelonephritis, you can definitely get fever and chills as symptoms.
4. Polycystic Kidney Disease or PKD
PKD, or polycystic kidney disease, is another disease that can cause kidney pain. And this is a genetic disease. In fact, PKD is the most common hereditary kidney disease. In our kidneys, we have nephrons, which are the functional units that help us to filter out blood, get rid of excess toxins, get rid of excess fluid, and to help us to maintain our balance.
In each kidney (most people are born with two kidneys), we have approximately one million nephrons. Well, in these nephrons, in addition to having tiny little blood vessels and we have a Bowman's capsule, we have these ducts and tubules. In polycystic kidney disease, you have these cysts, multiple cysts, that will form within these tubules. Now, the cysts themselves are benign. They are literally just like fluid-filled bags.
But when you get so many cysts, and especially when they start to grow and become numerous, they can actually affect the way that the kidney functions. These cysts can be anywhere from microscopic in size to multiple centimeters and very large. And the more cysts that you have, they can actually start to interfere with the function of your nephrons. And if it does that, it can cause a decline in kidney function.
The other thing that these cysts can do is they can cause pain. You have these multiple cysts and they can make your kidneys very, very large. And if the kidneys get large, they have to expand. They have to go somewhere, and they can actually be poking on your other organs, poking on your back, and they can cause certain blockages and obstructions in some cases. And so having polycystic kidney disease can definitely cause pain in the kidneys.
PKD can lead to other symptoms including:
- urinary tract infection
- urinary frequency
- urinary urgency
- blood in the urine
- cloudy, foul-smelling urine
If you're having some of these symptoms that could possibly be associated with polycystic kidney disease, be sure to consult with your physician because fortunately, we now have medicines that can help to slow down the progression of CKD, slow down the progression to end-stage renal disease, needing dialysis, or a transplant.
5. Kidney Trauma or Kidney Injury
Kidney trauma or kidney injury can definitely cause kidney pain, and all kinds of things can lead to kidney trauma. You can have a car accident, blunt force trauma if you're somebody who's into martial arts, or if you're just in a fight and you get knocked in your kidney. That can cause kidney trauma. And certainly, gunshot wounds or stab wounds to the kidney will be traumatic and can cause kidney pain. The important thing is this, knowing when to go in to see the doctor.
A lot of times when you have a car accident and the police and fireman come, they offer you to go to the ER. A lot of times after a car accident, your adrenaline's running, you don't feel any pain, you don't know what happened. But if you are having kidney pain after a car accident or some type of blunt trauma, you want to make sure that you consult with your physician or go to the ER to make sure that your kidney injury does not need some type of surgical intervention.
6. Kidney Cancer
Now typically, kidney cancer is silent in many cases, meaning there are no symptoms, you can be asymptomatic. But kidney pain, in some cases, can actually be a symptom of kidney cancer. It can be flank pain, side pain, or back pain. Now, kidney cancer, and renal cell carcinoma, are the most common causes. And while we don't necessarily have one pinpointed cause of kidney cancer, with renal cell carcinoma, there are some associated risk factors.
Some common risk factors for kidney cancer include:
- Cigarette Smoker
- High Blood Pressure
- Family History of Kidney Cancer
- Long-Term Dialysis Patient
- Hematuria or Blood In The Urine
- Night Sweats
- Unintentional Weight Loss
7. Renal Vein Thrombosis
Renal vein thrombosis is when one or both of the main renal veins that drain the kidneys get blocked. This will typically happen if someone has a blood clotting disorder like when their blood gets very thick it clots very easily. Or if they have something called nephrotic syndrome which can lead to a hypercoagulable state, or blood that clots. And basically, instead of the blood draining nicely from the kidneys and going to the inferior vena cava, and going the way it's supposed to go, you just get a big old clot there.
Renal vein thrombosis can definitely cause flank pain and may also result in the presence of blood in the urine, known as hematuria. It is important to remember that people with a history of clotting disorders, lupus (that leads you to have a hypercoagulable state), or conditions such as nephrotic syndrome or minimal change syndrome, someone who's been told you're leaking a lot of protein in your urine, may experience kidney pain. Therefore, it is crucial to be aware of these potential factors that can contribute to renal vein thrombosis and associated symptoms.
If you have any of these diagnoses and you have kidney pain, just think, renal vein thrombosis could be a possibility, and consult with your physician right away.
8. Autoimmune Diseases
Certain autoimmune diseases can actually lead to inflammation of the kidneys and cause kidney pain as well. That's kind of a little-known fact. Autoimmune diseases are diseases, where your body's immune system, instead of just fighting the bacteria, viruses, and foreign invaders that it's supposed to fight, your body's immune system turns on you and starts fighting you. Like an autobiography, is a book about oneself, and autoimmune disease is a disease that fights oneself.
Some examples of autoimmune diseases are:
- Lupus - With lupus, you can get something called lupus nephritis where you get inflammation in the kidneys, and if it happens acutely, rapidly or the the kidney swells, yes, it can cause kidney pain. It can also cause hematuria or foamy urine as well.
- IgA nephropathy - IgA nephropathy, is when you get that glomerular nephritis or that inflammation, it can cause pain on one side or both of the kidneys. It can also be associated with foamy urine, or "Coca-Cola" colored urine (blood in the urine).
Certainly, if you're having any of these symptoms, contact your physician immediately. When you have these autoimmune diseases like IgA nephropathy or lupus nephritis, in some cases, they can also cause swelling of the hands and feet. And this is edema.
Edema is when you get swelling or fluid in your tissues like in your hands, your feet, your ankles, and your legs. And oftentimes, if you press your fingers down, like on your legs or your feet, it might leave a pit or an imprint, and in that case, it's pitting edema. The nephrotic syndrome that I mentioned earlier, is something else that can be associated with edema, and that edema tends to be generalized, like your whole body is swollen.
Frequently Asked Questions About Kidney Pain
Now, I've covered definitely the top kidney pain symptoms and causes you should never ignore. But I will say, there are some questions that I get asked frequently about kidney pain.
Can Dehydration Cause Kidney Pain?
Now classically, dehydration won't cause kidney pain. However, if you get severely dehydrated, that can increase your risk for kidney stones, which of course can cause kidney pain. It can also increase your risk for renal vein thrombosis, which can cause kidney pain. So that's the link with the dehydration.
Can A UTI Cause Kidney Pain?
Yes, definitely. The urinary tract infection may start off in the bladder or like cystitis but if it ascends up to the kidneys causing pyelonephritis then definitely kidney pain can ensue.
Kidney Pain vs Back Pain - How Can You Differentiate?
Honestly, kidney pain and back pain can be very similar. They can both be in that costovertebral angle, kind of right down there below the ribs in your flanks and where the love handles are. And how do you know if it's like a muscle spasm or something that's being caused by a pinched nerve or herniated disc versus if is it your kidney? Well, the main way to know is by checking the urine. If you want to differentiate between the back pain and the urinary tract infection, you should see your doctor and ask for a urinalysis with micro. This is where they can look for white cells or signs of infection, and also a urine culture to see if there are bacteria growing. If you have a pinched nerve and back pain from muscle spasms, that is not going to be the cause of bacteria growing in the urine. So yes, a urinary sample (a urine culture) is how you can differentiate, but definitely consult with your physician.
If you found this article to be helpful and informative, please be sure to share it with the people you care about. I definitely want to empower you so you can have some knowledge of your own body and you can understand how these different kidney pain symptoms and causes can really be a hint of underlying kidney disease. I'm sharing this with you so that you can be your own advocate and you can go in and feel empowered when you see your doctor. It doesn't mean I want you to sit at home and "doctor on yourself", I still want you to consult with your physician if you're having some of these worries, some kidney pain symptoms. As always, I want you to do your best to live your healthiest, happiest lives. I'll see you next time.
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