Pain in the kidneys most often occurs with inflammatory lesions - pyelonephritis, glomerulonephritis. Pain syndrome occurs with nephroptosis, urolithiasis, emergency conditions (kidney infarction, renal vein thrombosis). Instrumental techniques are used for diagnosis: ultrasound, urography, CT. Laboratory tests of urine and blood are used. To clarify the diagnosis, a kidney biopsy is performed. Conservative treatment includes antibiotics, corticosteroids, diuretics, and antihypertensives. According to indications, hemodialysis or peritoneal dialysis, surgical intervention is prescribed.
In an acute process, back pain begins suddenly, against the background of complete health. Unpleasant sensations spread along the ureter, less often - radiate to the region of the anterior abdominal wall. The symptom usually appears after hypothermia, with inflammation of the urethra and bladder. The clinical picture is supplemented by febrile fever, chills, and malaise. Occasionally disturbed by dyspeptic disorders.
With a recurrent variant of chronic pyelonephritis, weak aching pains in the lumbar region are observed. The symptom is accompanied by discomfort in the abdomen, pain during urination, periodic fever. Such clinical signs persist for several months. It is characterized by a combination of kidney pain and high blood pressure.
Acute glomerulonephritis is manifested by moderate pain in the lower back, which is caused by stretching of the kidney capsule. For the disease, the onset of soreness is typical 2-3 weeks after a streptococcal or viral infection. In addition to the pain syndrome, morning swelling occurs, which are noticeable after sleep and are mainly located on the face. Often the daily diuresis decreases, the pink color of urine is less often determined.
In the chronic form of glomerulonephritis, the patient occasionally experiences mild pain in the kidney area. Signs of arterial hypertension with significant daily fluctuations in pressure indicators come to the fore. As in the acute form, persistent swelling is observed, most pronounced in the morning. Worried about shortness of breath and other symptoms of heart failure.
ICD with small stones for a long time is asymptomatic. Occasionally, there is mild pain on the side of the affected kidney. A typical clinic of renal colic appears when the ureter is blocked by a stone. An intense pain syndrome develops, which does not depend on a change in body position. Patients behave restlessly, trying to find a position in which the pain will decrease. Later hematuria joins.
Acute hydronephrosis is manifested by sharp paroxysmal pain in the projection of the affected kidney. They spread along the ureter, radiate to the thigh, to the perineum. This disease is characterized by frequent and painful urge to urinate, nausea, and vomiting. With infected hydronephrosis, the pain syndrome intensifies, combined with an increase in temperature to febrile values.
With moderate prolapse of the kidneys in the lower back, a pulling one-sided pain is felt, discomfort and heaviness in the abdominal cavity are also typical. Discomfort increases with bending, physical activity, disappears in a horizontal position. With a severe degree of nephroptosis, the pain becomes permanent and does not depend on the posture. With a complicated course of the disease, an attack of pain begins, similar to renal colic.
The intensity of pain is affected by the extent of the damage to the organ. With a massive heart attack, severe pain suddenly develops, which is similar in intensity to renal colic. They are located on one side. Because of excruciating pains, patients are restless, rushing around the room, unable to find a comfortable position. The pain syndrome is accompanied by hematuria, which is manifested by the release of pink or red urine.
Pathology belongs to the category of urgent conditions. Thrombosis is characterized by acute pain in the projection of the kidneys, the lateral parts of the abdomen. In addition to the pain syndrome, the patient feels a sharp deterioration in his condition, signs of intoxication increase - nausea and vomiting, weakness, drowsiness. Often there are systemic signs of the disease: pain in the lower extremities, their swelling and pastosity.
Benign cysts do not show up in any way for a long time. Pain in the kidney develops with an increase in the neoplasm in size, squeezing the surrounding tissues and nerve endings. Pain is given in the groin, thigh. With suppuration of large formations, chills and fever are noted, pain intensifies. Severe soreness, provoked by physical exertion, indicates the threat of rupture of the cyst.
With kidney cancer, pain is a sign of a running process. The pains are unilateral, dull, aching in nature. They are caused by stretching of the organ capsule, invasive tumor growth. At the initial stages, pain is absent. With malignant neoplasms of the kidney, a regular sequence of symptoms is observed: first, blood is found in the urine, and then pain occurs in the lumbar region.
When collecting an anamnesis, the nephrologist takes into account the duration of symptoms and events that preceded the manifestation of the disease. During a physical examination, Pasternatsky's symptom is checked, edema is searched. Decisive for identifying the causes of pain in the kidneys are the data of laboratory and instrumental studies. Diagnostics includes the following methods:
With symptoms of acute nephritis, renal colic, the patient is immediately sent for inpatient treatment. For mild to moderate cases, outpatient therapy is possible. Until the cause of the pain syndrome is identified, therapeutic measures include the organization of a sparing regimen, the selection of dietary nutrition with salt restriction. To alleviate the condition of a person, symptomatic therapy is carried out.
The patient management plan is determined by the clinical form of the disease and the etiological factor. For all types of pathology, a strict accounting of the amount of fluid drunk and the volume of diuresis is shown in order to monitor the excretory and concentration function of the kidneys. In some nephrological diseases, it is necessary to limit protein intake. Drug therapy includes a number of drugs:
With a significant violation of kidney function, replacement therapy is necessary - hemodialysis or peritoneal dialysis. The criteria for initiating treatment are pathological creatinine levels and insufficient glomerular filtration rate, changes in blood potassium, the presence of life-threatening complications, and renal failure.
In clinical urology, surgical techniques are more often used for urolithiasis, if there is no independent excretion of stones. With small stones, flexible retrograde nephrolithotripsy, contact lithotripsy is used, with large stones - nephrolithotomy. In severe developmental anomalies, total kidney damage, nephrectomy is performed. In terminal forms of renal failure, kidney transplantation is indicated.