I have kidney pain: symptoms, causes, treatments

The kidneys are sometimes compared to the « washing machine » of our body. Located under the last ribs, on either side of the spinethey help eliminate organic waste, filter the blood, maintain water balance and the correct level of minerals in our body, but also produce hormones and vitamins essential to the proper functioning of our body.

Their major drawback: they can be sick without anyone knowing it… So how do you know if it is kidney pain? When and who to consult? What support ? Answers from Corinne Isnard Bagnis, nephrologist, Professor at the Sorbonne University Faculty of Medicine and hospital practitioner at the Pitié-Salpêtrière Hospital (AP-HP).

« Kidney disease is silent, and mostly related to complications following diabetes or hypertension. Most of the time, it’s not the pain that identifies thembecause the kidneys, even when they are sick to the point of no longer functioning, are not painful », recalls the nephrologist.

The expression « to have pain in the kidneys » is regularly used, wrongly, to designate a pain located in the lower back (lumbago). But it sometimes happens that the kidneys are really the seat ofa sharp pain, located on either side of the spinein the lumbar region.

Difficult, a priori, to know if the pain really comes from the kidneys. Keep in mind that pain in the kidneys is quite rare, and very specific.

« Most of the time it’s actually pain in the back, in the lumbar region. It is not the kidneys that are painful, but the vertebrae or the muscles“, insists Professor Isnard Bagnis.

Kidney diseases are therefore usually not painful. In case of kidney pain, only a few specific cases can be blamed.

• Renal colic. « This phenomenon concerns about 10% of the population, at least once in their life », indicates the nephrologist. And to explain: « This is a particular situation, linked to the fact that a calculation (a small pebble) came out of the kidneys to go towards the bladder through the ureters (small muscular tubes which connect the kidneys to the bladder), and got stuck at the entrance to the bladder ». Result ? A very painful hyperpressure, linked to the retention of urine, which can no longer be evacuated. The pain is usually very sharp and requires prompt attention.
• Urinary tract infections can also cause kidney pain. Very frequent urge to urinate (pollakiuria), burning on urination, cloudy or malodorous urine… The symptoms are not wrong, it is indeed acystitisa lower urinary tract infection, very common in women.
• And if these symptoms are accompanied by intense fever, chills or abdominal or lumbar pain, it means that the urine infection has reached the kidneys. We then speak of pyelonephritis. « Most of the time, it is a complication of untreated or treatment-resistant cystitis », specifies Professor Isnard Bagnis.

Note: renal colic, cystitis or pyelonephritis are not considered as primary renal diseases, because they do not directly affect the filtration function of the kidneys. Kidneys victims of the obstacle represented by the calculation or the infection. However, if they are delayed in being treated, they can become complicated and generate sepsis or infectious shock. Acute or even chronic (sequel) renal failure can also occur.

« In case of renal colic, the pain is so intense that patients often go directly to the emergency room« , testifies the nephrologist. Only a health professional can make the difference and establish a reliable diagnosis to quickly prescribe the most suitable treatment!

As for urinary tract infections, often trivialized, they require a consultation of general medicine as soon as the symptoms appear, to limit a deleterious evolution. Pain should not be overlooked. If the episodes increase, depending on the clinical history and the various examinations, the general practitioner may refer the patient to a nephrologist or urologist.

Conclusion: if you think you are suffering from pyelonephritis or renal colic, contact your doctor or the emergency services.

The diagnosis always passes by the clinical examination and the interrogation. The doctor seeks to precisely identify the symptoms and trace the history of the pain.

• If he suspects renal colic, he can prescribe ultrasound or CT scan (scanner or computed tomography) which can identify any kidney stones, or even a malformation of the urinary tract.
• If he rather suspects a urinary tract infection or a kidney infection, he will prescribe a ECBU (a urine analysis examination) to be carried out in a medical laboratory to reveal – or not – the presence of bacteria.
• Finally, if he suspects more severe kidney damage, he may prescribe a creatinine testto assess renal filtration function, or an albumin assay (an albuminuria).

The treatment of pain is etiological, in other words, it depends on its cause.

In case of renal colic, management includes pain medication (like paracetamol) and anti-inflammatories to reduce the inflammation linked to the passage of the kidney stone, which causes the ureter to swell, specifies the nephrologist.

In case of cystitis or pyelonephritis, antibiotics will allow you to overcome the bacteria that is the cause. Please note that processing can take 7 to 14 days depending on the case.

Treatment by dialysis, kidney transplant or kidney transplant is offered when the kidneys are no longer capable of carrying out their missions, for example, in the event of advanced renal failure », specifies the nephrologist.