Known  mostly for their waste removing functions in our bodies, kidneys are  bean shaped organs. They look like two sprouting beans attached opposite  each other and separated by venacava, the aorta, and other  gastrointestinal organs.
Kidney Location (Anatomy)
- Anatomically, they are positioned on your back; or more precisely,
- Just under both the lower ribs (4 ).
- The areas may probably and clearly explained as the upper abdominal area but on the backside usually near the back muscles.
- They are intricately hidden in the abdominal region, right next to the liver and the spleen
- Owing to their peculiar opposite positions, both kidneys are on not the same level.
- The  right kidney lies lower and just under the diaphragm, while the left  kidney being slightly higher due to the large size of the liver.

Picture 1 : Where are the kidneys located in relation to quadrants?
The  delicate and vital organs, are surrounded by layers of fat, and are  protected by the ribcage, muscles, as well as each having a layer of  connective tissues. On the back, they will feel as though they are  deeply embedded on each side of the spine as depicted in the diagram  below (1).
On a surface, here is where the Kidney is found

 

 
Viewed  from behind, the kidneys shown by the arrow and appear right at the  inner part of the lower ribcage area. The left kidney is positioned  higher on the ribcage area and next to the spleen. It may appear smaller  in size in women and children as opposed to the male gender. The right  kidney slighly lower is is not tottally enclosed by the ribcage and  liver and the lungs.

The above diagram shows the position of each kidney viewed from the front side.
 
Various Types of Kidney Pain
There  are several types of pains attributed to the kidney, most of which are  in the back area of your body and often in the upper region near the  ribcage areas, just above the hips. Unlike the lower back pains that are  most severe (5);
- Most kidney pains will be dull
- Felt on either side of the spine region.
- However, the pain can be quite painful especially when there is presence of kidney lacerations or kidney stones.
- One  paramount difference with other back pains is that all kidney pains  will be accompanied by high fevers, nausea and in some cases lead to  vomiting.
- The pains caused by kidney stones will be wavy-like, moving from the upper backside to the front hip area (2).
- Unlike  back pains that will restrict back movements, severe kidney pains are  comparable to Labour pains, affecting the movement of every other part  of the body.
- With  back pains, one feels the pain on simple movements of the body; it  actually becomes difficult to move. Kidney pains will be delayed after a  move although in severe cases, the pain may be more elaborated and  affect the body movements or exercises.
 
How to know if you are experiencing Kidney Pain
- Most kidney pains will be dull. This is especially when kidney disease is on the onset.
- With chronic kidney disease, the pain will however be severe.
- Since  onset kidney pains are rarely specific, they can be confused with side  organs pains such as the spleen, colon, or even the gallbladder.
- The only difference in these kidney pains is that they will be cramping.
- They may be sudden, recur once in a while or persist in chronic conditions.
- The  pains will be felt on one side of the infected kidney or both sides of  the back region in cases where both kidneys are infected.
- This  pain will either throb, or just appear either once as sharp and deeply  piercing pains that can be mild or in some cases quite severe .
- Severity  of most other back pains increases with body movements. Kidney pains  will be consistent and steady, body jerking, exercising will not alter  the severity.
- To  confirm if the pains are indeed related to kidney infections, the  symptomatic pains will be accompanied by fever, fatigue, nausea, and  most often, vomiting.
- The flank joint area will also be in pain or discomfort and especially the groin region.
- In case of pains caused by injury, there may be presence of injurious pain
- And  if infections are the primary cause, the reproductive system will also  be affected causing similar discomforts or most urinary tract diseases.
Kidney Stone Pains
- The sudden and severe kidney stone pain increases in intensity and usually comes in a wave (6).
- The  pains will be elaborated in the groin or genital regions, moving to the  abdomen and round at the back area. It is neither permanently in the  stomach region nor at the back as the pain is forever shifting (3).
- The  stones if small do not cause pains as they pass out through the urine.  If large or many, they may however block the urinary tract in various  place and therefore their sizes may not be signifanct to the pain felt.  Since they are on the move, the pain will also be in various places in  the urinary tract.
- Depending on the severity of the infection, the pains will also be more severe on the most affected area.
- Sharp pains that will abruptly be either on one back area or both or in the lower abdominal areas extending to the groin region.

Some of the Kidney Diseases and their Associated Pains
| Disease | Associated pain | 
| Kidney stones | Pains  are as indicated above usually begins as dull aches in the left or  right back regions, extending to sharp and constant pains in hours. May  also be accompanied by heavy breathing, nausea, and even blood in the  urine. | 
| Obstruction of Urethra | Congenital,  infections and surgeries are the likely causes. Side back pains usually  after having a drink. There may be a mass in the upper abdominal region  that may also cause more pains. | 
| Loin Pain Hematuria Syndrome | Caused  mostly by infections, hormonal imbalances and frequent use of  contraceptives, it mostly affect women. Persistent pains with burning  sensations around the loin region with fever and nausea. The pain  progreses into throbbing busts that gets worse with movements. | 
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There  are several other kidney ailments but most, which are accompanied by  flank pains. These ailments includes but not limited to various cancers  of the urinary tract systems, renal cysts, nephrogenic diabetes,  glomerulonephritis, hydronephrosis, and a host of other related kidney  ailments. The remarkable difference in kidney pains with any other pains  is that kidney pains will be accompanied by fever and nausea.
Difference between Kidney Pain and Back Pain
| Kidney Pain | Lower Back Pain | 
| Sudden and consistent | May be sudden but persistent | 
| On either backside, | Usually lower back | 
| Pains moves to other regions | Pains mostly on one central area | 
| Not affected by movement | Increases with body movement | 
 
 
Causes of Bilateral and Unilateral Kidney Pains
Flank  pains experienced in either one side otherwise known as unilateral, or  both sides, which is referred to as bilateral is caused by various  reasons (3).
- The most cause of kidney pains or flank pains is kidney stones.
- Obstructive uropathy. This is the process of having urine passing in the opposite direction usually because of blockages in the urinary tract.
- Pyelonephritis. This is the inflammation of the kidneys and the urinary tract.
- Urinary Tract Infections. Covering a wide range of infections, they affect the entire process of making and transporting the urine from the body.
- Appendicitis. Attached to the large intestines, this vital organ if full or inflamed will also cause flank pains.
 There  are several other causes of flank pains like bladder cancer, injuries,  obesity related pains, obstructions on the renal tract, hydronephrosis,  shingles, Hodgkin’s disease amongst others (7).
Does Kidney Failure Cause Pain
A progressive of kidney ailments causes kidney failure (8).  Often irreversible, kidney failure is detectable through symptomatic  causes that can be treated early but if progressed, the only remedy for  kidney failures is transplants and dialysis. Owing to the fact that  there may just be one kidney malfunction, the obvious symptoms may not  be present and thus will go undetected. You will know it is chronic when  both kidneys are affected (3).
- There  may be little or no pain at this stage, directed exactly at the kidneys  but because of the effects of a kidney failure, pains may be around the  thoracic region due to fluids building up and shortness in breathing.
- In  the initial phase culminating to kidney failure, there is the kidney  pains associated with either each back pain or both sides of the spinal  region.
- If  the pains are related to infections, there will definitely be abdominal  pains and if the kidney pains are as a result of kidney stones, most  definitely severe pains in these kidney regions.
- Since it is rarely accompanied by pain, kidney failure will mostly be noticeable by (9)
- Nausea and vomiting,
- Fever and persistent itching,
- Fatigue and remarkable body weakness,
- Loss of weight and general malaise.
- The most distinguishing symptom is high and erratic blood pressure that is difficult to control,
- Frequent urination with a feeling of incontinence and sometimes accompanied by either dark coloured urine or with blood.
- There will also be remarkable swelling of the feet and especially the ankles,
- Muscle twitches and cramping as well as frequent hiccupping.
- Sleeping  patterns will be adversely affected, resulting to long hours of  sleeplessness that decreases the mental thinking capacity (3).
References
- Charles  Patrick Davis P. Kidney Pain: Get the Facts About Symptoms and Causes  [Internet]. MedicineNet. 2015 [cited 4 December 2015]. Available from:  http://www.medicinenet.com/kidney_pain/article.htm
- Nhs.uk.  Chronic kidney disease – NHS Choices [Internet]. 2015 [cited 4 December  2015]. Available from:  http://www.nhs.uk/conditions/Kidney-disease-chronic/pages/introduction.aspx
- WebMD.  The Basics of Kidney Disease [Internet]. 2015 [cited 4 December 2015].  Available from:  http://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information
- Casteleijn,  Niek F., et al. “Chronic kidney pain in autosomal dominant polycystic  kidney disease: a case report of successful treatment by catheter-based  renal denervation.” American Journal of Kidney Diseases 63.6 (2014):  1019-1021.
- Cohen,  Debbie L., and Michael C. Soulen. “A Patient with Acute Kidney Pain and  High BP.” Clinical Journal of the American Society of Nephrology  (2015): CJN-10171014.
- Davison,  Sara N., Holly Koncicki, and Frank Brennan. “Pain in chronic kidney  disease: a scoping review.” Seminars in dialysis. Vol. 27. No. 2. 2014.
- Ksl.com/?sid=37320617&nid=1352&title=worst-pain-ever-childbirth-or-kidney-stones&s_cid=queue-7
- Webmd.com/news/20151105/early-warning-sign-for-kidney-disease-identified-in-study
- Sciencedaily.com/releases/2015/12/151203081800.htm
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