Kidney

Kidney pain - causes and therapy

Kidney pain - causes and therapy


We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

Kidney pain is felt to the left and right of the spine approximately in the area between the twelfth thoracic vertebra and the third lumbar vertebra. They are also described as flank pain and can occur on one or both sides. In view of the symptoms, many affected people mistakenly think of back pain or complaints of the musculoskeletal system instead of a kidney disease. Kidney problems can certainly be related to a more serious illness and should be examined urgently by a doctor.

The function of the kidneys

The kidney is a paired, bean-shaped organ of the urinary system. The two kidneys are located in the human body to the left and right of the spine below the ribs and are about 12 centimeters tall. An essential task of the organ is the excretion of the urinary substances, which are the end products of the metabolism in the organism. The urine also excretes toxic substances that could otherwise lead to health problems. The kidneys generally play an important role in regulating the water balance, blood pressure and acid-base balance.

The organ has a decisive influence on the formation of certain hormones. In addition, the blood's electrolyte content is largely determined by the kidneys. These are formed from numerous so-called nephrons (kidney corpuscles and kidney tubules), which separate preservable substances from substances to be excreted in several steps. Real kidneys filter more than 1,000 liters of blood a day. The blood is freed of the harmful substances and these can then be excreted in the urine. The substances useful for humans go back into the bloodstream. Due to their filter function, the kidneys are also colloquially referred to as detoxification organs.

Causes of kidney pain

Triggers can be various diseases of the kidneys and urinary tract. Congenital and acquired malformations should be mentioned here, as well as viral or bacterial infections, overloading with medication, various systemic diseases, hereditary diseases and tumors. Kidney stones and urinary retention or reflux can also cause pain in the kidney area. In rare cases, the symptoms are caused by a so-called sarcoidosis (special connective tissue disease). The following is an overview of the most common causes of kidney pain.

Kidney stones and ureter stones

Relatively often, the complaints hide crystalline deposits in the kidneys or urinary tract, which are either generally called urinary stones or (depending on their location) ureter stones and kidney stones. Urinary stones can be very different. Uric acid crystals, oxalates and urates are often components of the deposits.

The formation of kidney and ureter stones is often due to nutrition. For example, protein-rich food such as meat is considered to be beneficial for the development of urinary stones, but coffee consumption is also considered a possible influencing factor. Furthermore, a hereditary breakdown in the breakdown of certain components of the diet can occur, which leads to the formation of large amounts of uric acid in the blood.

The pain in ureteral stones is usually extremely severe and occurs like a spasm. They are caused by the stretching of the ureter in which the stone is located. The pain can be felt as back pain or flank pain. Some sufferers also complain of abdominal pain that extends to the genital area.

Inflammation of the kidney

The cause of the symptoms can be a kidney infection. This inflammation, usually referred to as pyelonephritis in the specialist world, is usually caused by pathogens that rise from the bladder via the ureter. For example, intestinal bacteria of the genus Escherichia coli, but also stickies, enterococci and special staphylococci can lead to kidney inflammation. In rare cases, the inflammation is caused by a fungal infection with the yeast Candida albicans.

Because of the shorter urethra, women get sick much more often than men. In addition to the kidney or flank pain, the patients often suffer from accompanying symptoms such as urinary problems, fever, chills, dizziness, nausea and vomiting.

To prevent the development of chronic renal pelvic inflammation, drug treatment with antibiotics or antifungals (for infections with Candida albicans) is usually indispensable. If the disease progresses to a chronic stage, the symptoms usually also change, and those affected show more general symptoms such as reduced performance or concentration, chronic fatigue, loss of appetite and headache.

Inflammation of the kidneys

Inflammation of the kidney corpuscles and the kidney connective tissue is called kidney inflammation. This can also be the cause of the complaints. In the broadest sense, kidney pelvic inflammation is also a form of kidney inflammation, but a separate consideration is given here.

If there is inflammation of the kidney corpuscles, the medical term is glomerulonephritis. Inflammation of the renal tubules and the kidney connective tissue is called interstitial nephritis. As the different names make clear, different areas of the kidneys can be affected, which in turn can be accompanied by different accompanying symptoms.

Inflammation of the kidney corpuscles is not uncommon after a survived viral, bacterial or mycogenic infection. They result from the deposition of so-called immune complexes (antigen-antibody complexes) in the kidney area. For example, glomerulonephritis after streptococcal diseases is worth mentioning.

Typical symptoms are hematuria (increased excretion of red blood cells with the urine), proteinuria (increased protein excretion with the urine), a decrease in urine production and edema in various parts of the body, since the balance of body fluids in the inter-cell spaces, cells and vessels is disturbed . Hypertension can also be part of the clinical picture of inflammation of the kidneys. Other possible causes of inflammation of the kidneys are damage from toxic substances and certain medicines.

Kidney pain from injury

The pain in the kidney area can be attributed to external violence, for example in the event of falls, traffic accidents or physical conflicts. In this case, the clinical picture is called kidney contusion. In addition to the pain, hematomas (bruising) can often be observed as an accompanying symptom.

Fractures (such as broken ribs) and trauma injuries to other internal organs are often associated with kidney trauma. Depending on the extent of the injury, blood residues can be seen in the urine with the naked eye or under the microscope. If there is severe internal bleeding in the course of the kidney trauma, this can lead to a life-threatening breakdown of the circulation.

Narrowing of the urinary tract / urinary retention

Obstacles to drainage of the urinary tract, such as narrowing due to tumors or blockage by urinary or kidney stones, can lead to urinary retention (obstructive uropathy), which in turn is often accompanied by pain. Due to the build-up of urine, the susceptibility to infection and the risk of inflammation of the kidney are increased. The increased pressure in the kidney can also lead to tissue death.

If the narrowing of the urinary tract is not removed, there is a risk of extensive scarring of the kidney tissue and the development of a so-called shrinking kidney. Furthermore, so-called hydronephrosis (sac kidney or water sac kidney) may form in the course of the urinary congestion. Urinary congestion can also be observed in connection with neurogenic bladder emptying disorders, as can occur in various neurological diseases.

Urinary reflux

Urinary drainage disorders can lead to urine backflow or backflow into the kidneys. Depending on where the urinary drainage is blocked, one-sided or bilateral kidney problems can be observed. An obstacle to drainage immediately after a kidney leads to urine reflux in this very organ. If the causes of the urinary drainage problem are in the area of ​​the urethra or bladder, the symptoms appear in both kidneys.

Numerous causes can be considered as triggers of urinary reflux, the spectrum ranging from congenital malformations to urinary stones and inflammation to uncontrolled tissue growth in the form of malignant tumors. A distinction is made between acute and chronic forms. In the acute case, cramp-like kidney pain occurs, which may radiate into the groin area. Chronic forms, however, often only become noticeable when the kidney tissue dies.

Cystic kidneys

Cystic kidneys are usually hereditary and are characterized by the concentrated appearance of tissue chambers with contained body fluid in the area of ​​the kidneys. In contrast, kidney cysts are individual cysts in the kidney area that usually represent a rather harmless symptom.

The first signs of hereditary cystic kidneys usually appear from the age of 20. For example, those affected have blood and protein residues in the urine, show permanently high blood pressure and suffer from kidney pain. However, it is not uncommon for the disease to remain completely without symptoms until complete renal failure with correspondingly far-reaching consequences occurs relatively suddenly.

Cause kidney infarction

Another possible cause is the so-called kidney infarction. Due to a locally formed or washed-in blood clot (thrombosis or embolism), the kidney tissue is only insufficiently supplied with blood in the renal arteries. The lack of blood circulation or the associated lack of oxygen lead to the death of the tissue.

Typical complaints with such a kidney infarction are persistent flank pain, blood residues in the urine, increased white blood cells in the blood (leukocytosis) and, in the worst case, acute kidney failure.

Kidney cancer

A malignant kidney tumor can also be used to trigger kidney pain. The clinical picture is called kidney cancer. The most common form is renal cell carcinoma or kidney cell cancer.

Complaints can include, for example, blood residues in the urine and kidney pain, but often the disease initially goes rather inconspicuously with unspecific complaints such as loss of appetite, chronic fatigue and possibly fever. In the late stage, the tumors can also be felt from the outside.

Urogenital tuberculosis

Urogenital tuberculosis arises in the course of tuberculosis when the pathogens reach the kidneys, urinary tract and bladder via the bloodstream. Here the pathogens form a so-called tuberculoma, which is a type of calcification with living tuberculosis pathogens contained therein. If the immune system cannot successfully remove this, the calcifications spread and the kidney tissue begins to die off. In the long term, this will severely damage the kidneys and form a so-called putty kidney, which is characterized by a large number of tuberculomas and can no longer perform its actual function.

Symptoms of urogenital tuberculosis include flank pain, hematuria, ice residue in urine, problems with urination and more unspecific symptoms such as bloating or constipation. However, urogenital tuberculosis is rather rare today.

Renal vein thrombosis

If a thrombus forms in the renal veins, this leads to blood congestion in the kidneys, which can lead to different symptoms depending on the extent and location of the renal vein thrombosis. Hypertension, severe kidney colic, flank pain and abdominal pain are possible symptoms here.

Partial occlusions of the renal veins, on the other hand, are often symptom-free or are initially accompanied by only slight permanent pain. The consequence of renal vein thrombosis is the death of the kidney tissue, which causes an increasing impairment of organ function with corresponding further complaints. Renal vein thrombosis can be caused by a wide variety of factors, such as general blood clotting disorders, kidney trauma or, for example, an acute lack of fluid or internal dehydration.

Walking kidney

In some people, the kidneys are unusually flexible or mobile. This causes the organs to slip, which in turn means that the blood vessels and ureters are impaired. A typical feature is pain in the kidneys or flanks that subside when lying down. Nausea, vomiting and reduced urine production can also occur as more unspecific complaints. Women suffer more from the symptoms than men, whereby the risk immediately after birth is rated as particularly high.

Diagnosis

The diagnosis is based on a detailed questioning of the patients about the complaints. If this leads to the suspicion of kidney disease, a urine sample is first tested in the laboratory for blood residues, protein excretion, nitrite, pus, bacteria and other conspicuous ingredients. A blood test can provide important information about the diagnosis (for example, evidence of leukocytosis in kidney inflammation).

Imaging methods such as sonography, computed tomography or magnetic resonance imaging are used to further narrow the complaints. The so-called kidney scintigraphy, in which the patient is injected with a contrast agent so that the tissue structures can then be viewed with a gamma camera, is a particularly specialized diagnostic tool. To ensure the diagnosis of kidney cancer, but also of various other kidney disorders, the taking of a tissue sample is carried out required in the context of a so-called puncture.

Therapy for kidney pain

Basically, the treatment of kidney pain aims to remedy the actual cause. Accordingly, the required therapy steps can vary significantly. Most triggers can be successfully treated with medication, but in some cases surgery and possibly the transplantation of a donor kidney may be necessary.

Treatment of kidney and ureter stones

Urinary stones with a high urate and cystine content can usually be removed relatively well with the help of special medicines. However, not all kidney stones can be remedied in this way. In these cases, further treatment steps are required. For example, the so-called extracorporeal shock wave lithotripsy is available as a non-invasive procedure, in which the urinary stone should be crushed from the outside with the help of more targeted sound waves. The smaller parts can then be excreted via the urinary tract.

It is possible to introduce a special examination and treatment instrument (endoscope) over the urethra, which offers various options for removing ureter stones (e.g. destruction by ultrasound or laser). In so-called percutaneous nephrolitholapaxy (PNL), the endoscope is inserted through a small incision in the skin and then the urinary stones are broken up (usually by means of shock waves). If the comminution is successful, a ureteral splint is usually used to widen the ureter and facilitate the excretion of the urinary stone fragments.

Therapy for inflammation in the kidney area

In most cases, inflammation of the kidney is treated with antibiotics. If the inflammation is due to a fungal infection, so-called antifungals are used. If complications such as urinary congestion, the formation of abscesses or signs of blood poisoning can be observed, surgery or, if necessary, removal of the affected kidney (nephrectomy) may also be necessary if the kidney is inflamed.

Not every kidney infection needs therapy, but a medical examination should always be done. The cause is determined and, if necessary, targeted treatment is initiated. Regular urine checks are used to monitor the course of the disease. In acute forms that are based on an autoimmune reaction, short-term immunosuppressive drugs (especially Corison) are often used. Draining medicines can be used to combat the edema that forms in severe forms of kidney inflammation. However, special care should be taken when using them to avoid possible negative consequences from increased fluid excretion.

Medical care for kidney trauma and cystic kidney

In most cases, minor trauma injuries to the kidneys are treated conservatively and preserving organs. With close monitoring of the patient, an operation is initially avoided. This also applies to severe kidney trauma, whereby an operation is often necessary in the later course, while the mild kidney trauma usually heals easily without intervention.

Indications for an absolutely necessary operation are, for example, open kidney injuries such as a bullet or stab wound. Surgery is also used if the circulatory status of the patient cannot be stabilized, the ureter and kidney pelvis are separated from one another due to the narrowing, or if there are further internal injuries.

If kidney pain is due to a cystic kidney, dialysis is usually necessary in the long term, followed by a kidney transplant if possible, since healing cannot be achieved either by medication or by surgical removal of the cysts. There is currently intensive research into further therapy options, but despite promising first results, successful drug treatment is not yet in sight.

Treatment of urethral constriction, urinary retention and urinary reflux

If there is a urine congestion, there are various treatment options, whereby the causes of the complaints are also based here. For example, the narrowing can be widened by means of an inserted catheter (ureter splinting), the pent-up urine can be passed outside via a tube (nephrostomy) and / or the underlying infection can be treated with antibiotics.

Nephrostomy is also an option in the case of urinary reflux to provide relief in the short term. However, the causes must then be eliminated. Blocking urinary stones - as well as any existing tumors - must be removed to avoid reflux.

Medicines and procedures for renal infarction and renal vein thrombosis

In the case of a kidney infarction, drugs are usually used to inhibit blood clotting, to relieve pain and to regulate blood pressure. Further therapy with blood-thinning medication in the form of so-called lysis therapy may also be necessary. In the worst case, surgical removal of the thrombus is planned.

Renal vein thrombosis is also treated with anticoagulant medication, which requires taking over several months. Sometimes those affected have to take medication for their whole life.

Kidney cancer therapy

As long as no metastases have formed, kidney cancer is treated with the help of surgical removal of the tumor. Smaller tumors can be removed, for example, using the minimally invasive method of cryotherapy (icing treatment). However, the tumor must not be larger than four centimeters for this.

With large tumors, a complete removal of the kidneys and the surrounding tissue is usually provided. Today, various, relatively new drugs are used to treat metastatic forms of kidney cancer as part of a so-called drug-based system therapy, which also enables healing at this stage of the disease.

Medical measures for urogenital tuberculosis and walking kidneys

Urogenital tuberculosis is treated with special antibiotics that have to be taken over a period of several months. If the treatment does not show the desired success and / or if the kidneys are increasingly damaged, an operation or surgical removal of the affected tissue may also be necessary.

In most cases, the symptoms of hiking kidneys are successfully treated with conservative therapy. By strengthening the abdominal muscles with simultaneous support by a corset, the exceptional mobility of the kidneys can be significantly reduced and, at best, the symptoms go away completely. However, a cure cannot always be achieved on the basis of conservative treatment. In these cases, surgery can be performed in which the kidneys are “attached” to the psoas muscle.

Naturopathy for kidney pain

Many causes cannot be remedied by naturopathic methods - but naturopathy can often make a helpful additional contribution to treatment. For example, in the case of inflammatory diseases of the kidneys and urinary tract, herbal medicine relies on extracts from bearberry leaves, buckthorn, nettles, parsley, horsetail, birch leaves, goldenrod, quark rootstock, verbena and other medicinal plants.

In the field of homeopathy, preparations such as Nux vomica, Cantharis, Acidum benzoicum, Berberis and Eucalyptus are used against inflammatory processes in the kidneys and urinary tract.

Nutritional therapy also uses a special diet with a reduced salt content, low sugar, low protein content and largely omitting fatty foods. Which diet is suitable here depends on the individual symptoms and the general condition of the person concerned. A balance in the acid-base balance is also sought through the diet, since there may be a connection between the kidney complaints and an existing acidity of the body.

In naturopathy, teas made from verbena, celandine (water pepper), broom, messesweet or woodruff are used to combat kidney stones. Furthermore, a decoction can be created from various medicinal plants and then taken in. Dog roses, real celery, broad beans, ash bark, horsetail, hawthorn, knotweed or dandelions are well suited for this.

For kidney stones, homeopathy offers remedies such as Acidum benozoicum, Acidum oxalicum, Berberis vulgaris and Coccus cacti. Here too, an accompanying change in diet is particularly important. Low-fat and low-protein food, a high calcium intake (inhibits oxalate absorption in the intestine) and a reduced salt intake form the basis of the treatment.

Since the formation of kidney stones from calcium oxalate is favored by an increased oxalate intake, foods with a high oxalate content, such as spinach, rhubarb, sorrel, sour clover or chard, should be avoided as far as possible. Meat consumption should also be reduced. A preventive effect on kidney stones is attributed to the consumption of (diluted) lemon juice - for example in the form of homemade lemonade - because the citrates contained counteract the formation of stones.

Naturopathy can achieve remarkable treatment successes for kidney infections as well as for kidney pelvic infections and kidney stones. However, medical supervision is urgently required and self-therapeutic measures are not recommended. In the case of other (severe) kidney diseases such as a cystic kidney or kidney cancer, no cure is possible based on naturopathic treatment, so there is no way around conventional therapy - possibly with kidney removal or even a kidney transplant. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

  • Institute for Quality and Efficiency in Health Care (IQWiG): Kidney stones and ureter stones (accessed: 05.09.2019), gesundheitsinformation.de
  • Wolfgang Kühn, Gerd Walz: Autosomal dominant polycystic kidney disease, Dtsch Arztebl 2007; 104 (44): A-3022 / B-2660 / C-2579, (accessed September 5, 2019), aerzteblatt.de
  • Giovanni Cavagna: Kidney, Fundamentals of Human Physiology, pp. 217-249, Springer International Publishing, 2019
  • Wilfried Druml et al .: S1 guideline of the German Society for Nutritional Medicine (DGEM): Enteral and parenteral nutrition of patients with renal insufficiency, (accessed September 5, 2019), AWMF
  • Anna Malkina: Chronic Kidney Diseases, MSD Manual, (accessed September 5, 2019), MSD
  • Anna Malkina: Acute Kidney Injury (AKI), MSD Manual, (accessed September 5, 2019), MSD
  • J. Braun, D. Müller-Wieland, H. Renz-Polster, S. Krautzig: Basic textbook on internal medicine, Urban & Fischer Verlag / Elsevier GmbH, 6th edition, 2017
  • Noel A. Armenakas: Nierentrauma, MSD Manual, (accessed September 5, 2019), MSD
  • Michael Field, Carol Pollock, David Harris: Understanding Organ Systems - Kidney: Integrative Foundations and Cases, Urban & Fischer Verlag, Elsevier GmbH, 1st edition, 2017
  • Thomas Gasser: Basic knowledge of urology, Springer Verlag, 6th edition, 2015

ICD codes for this disease: N23ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


Video: KIDNEY STONE HOME REMEDY (October 2022).