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 Kidney

November 2011
Causes of Kidney Pain
Dr Mohammed A.Rafey
 
The kidneys are vital organs in the human body that are essential to sustain life. Apart from waste excretion, they help in regulating the acid-base balance of the body and maintaining the blood pressure.

Unlike several other organs in our body, it is less common for the kidneys themselves to be painful or cause pain. In fact, the most common kidney disease in the world, chronic kidney disease or CKD, does not typically present itself with kidney pain.

Some disease conditions that may be present with pain in the area where the kidney is located:
  • Kidney stones: Kidney stone pain usually develops as the stone moves from the kidney into the urinary tract. This pain may range from a mild discomfort in the flank area to severe agonizing pain that occurs in waves. If the pain is severe, it may be accompanied by nausea and vomiting.
  • Urinary tract infection: The other important cause for kidney pain is severe urinary tract infection that involves the kidney. Patients in this condition manifest flank pain, abdominal pain, often accompanied by fever and a burning sensation when passing urine.
  • Urinary tract obstruction: The obstruction to urinary flow can occur as a result of a kidney stone, ureteral stricture (narrowing of the urinary tract) or tumour. The pain may be minimal or mild when the obstruction is gradual, but can be acute and severe when obstruction occurs suddenly.This pain is similar in characteristic and quality to the pain that is caused by kidney stones.
  • Polycystic kidney disease (PKD): Multiple cysts develop in the kidney that can progressively increase in size leading to enlarged kidneys and renal failure. The rapid enlargement of these cysts, sometimes with bleeding, can cause pain. In some patients, flank pain develops as a result of infection of these cysts.Since PKD patients are at a higher risk of developing kidney stones, it is important to investigate for and rule out kidney stones as a cause of pain in these patients.
  • Renal cell carcinoma: This type of cancer of the kidney usually presents itself with flank pain, blood in the urine, and a mass in the abdomen. These patients may also have symptoms of weight loss due to the malignancy and anemia, as the kidney is not able to perform its function in red blood cell formation.
  • Page Kidney: Blunt trauma in the area of the kidney can lead to bleeding within the kidney tissue. As bleeding can increase the pressure within the kidney, there can be pain in the flank as well as onset of hypertension.
  • Loin-pain hematuria syndrome: This is a very rare kidney disease in which patients present infrequent episodes of blood in urine associated with flank pain.
While the management of kidney pain itself is symptomatic in nature, it is important to investigate for and treat the underlying kidney disorder to achieve resolution and complete relief of pain. 
Common interventional and surgical treatment procedures for kidney disease
Lithotripsy – is a non-invasive procedure to remove kidney stones. A focused high intensity shock wave breaks up the stone in kidney or urinary tract and the tiny pieces of stone pass into the urine. The cost of lithotripsy ranges between Rs.40,000 to 60,000.

Kidney transplant - is usually recommended when both kidneys are irreversibly damaged. The patient with kidney failure receives a kidney from a close healthy relative who has agreed to donate one of his kidneys, or from a relatively healthy patient who died of a disease not related to kidney. The cost of this procedure may range between Rs.4 to 6 lakhs.


    
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