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 Kidney

March 2012
Back Issues with the Kidney
Dr Sanjay Maitra
 
It may not always be so, but back pain may be
an unusual manifestation of an underlying
kidney disease and it is good to be aware of it.

Nearly everyone has low back pain sometime. Men and women are equally affected. Data from the US suggests that backache is the second most common neurological complaint, after headache. It is the most common cause of job-related disability and a leading cause for missed work.

Though not always, but back pain may be an unusual manifestation of an underlying kidney disease and it is good to be aware of it. Put in another way, at times, diseases of the kidney and its allied structures may present with back pain. If not recognized early they may lead to problems and kidney malfunction later on.

Moreover, patients with deranged kidney function may be taking pain medicines without knowing the exact nature of the disease and cause severe damage to their kidneys. Thus the exact cause of back pain must be ascertained in each patient before pain medicines are prescribed liberally.

Kidney and allied diseases causing back pain
  • Renal, ureteric or bladder stones
  • Urinary tract infection
  • Congenital diseases of kidneys causing enlarged kidneys as in Autosomal Dominant Polycystic Kidney Diseases (ADPKD)
  • Acute nephritis may present initially with back pain
  • Patients with mild kidney dysfunction and back pain due to musculoskeletal disorders may go into severe renal failure while taking painkillers
  • Patients of advanced renal failure and those on dialysis may have severe back pain due to osteoporosis and osteomalacia
  • Obstruction of urinary flow due to either prostate cancer or cervical cancer It may not always be so, but back pain may be an unusual manifestation of an underlying kidney disease and it is good to be aware of it. B Healthy 14 B+ve March I 2012
  • Metastasis to the bones from cancer – prostate or lymph nodes from testicular cancers
  • Certain blood cancers like multiple myeloma present with severe back pain and frequently have renal failures too.
What to do in case of backache?
Unless the cause is obvious like a minor injury causing mild back pain it is better to consult a doctor.
  • Back pain severe enough to prevent normal movements or those causing numbness in the feet and muscle weakness demand immediate attention. Before taking painkillers get in touch with a doctor to determine the cause and to ensure that your kidney functions are normal.
  • If you have any problems in passing urine freely or you are passing blood, small stones or are having burning sensation you could be having an underlying kidney disease.
  • Persons with young age diabetes and / or hypertension or past history of renal stones or any other kidney problems may be having an underlying kidney disease and should be more cautious before taking medicines.
What will your doctor do?"
Depending on your symptoms and mode of presentation he will order a number of tests that he thinks appropriate. As regards renal diseases causing back pain, the treatment depends on the exact cause.
  • If your backache is due to renal stones, prostatic enlargement or cancer you need to visit a urologist for appropriate management.
  • Urinary infections need appropriate antibiotics and sometimes surgical intervention to clear associated obstruction.
  • Acute nephritis and other medical conditions are best dealt with by a nephrologist.
  • Any patient with kidney dysfunction needs to be given painkillers and other medicines carefully to ensure that the kidneys are not severely damaged.


    
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