Kidney Injuries

The kidneys are 2 organs that lie on either side of the spine between the middle of the back and the front of the abdomen. Kidneys filter the blood and remove excess water (urine) from the body. An outside force (trauma), immune response, medicine, procedure, or acute condition or disease can result in injury to the kidneys. When this happens, the kidneys cannot function properly. Injury may be mild to severe.

CAUSES

Bleeding, swollen (inflamed), blocked, or damaged blood vessels of the kidney may be the result of several conditions.

  • Birth defects (congenital conditions), chronic conditions, or life-threatening conditions, such as:

  • Weakness in a blood vessel (aneurysm).

  • Blockage in the heart or arteries.

  • Abnormal connection between an artery and a vein (fistula).

  • Blood clot (thrombosis) in the vein that drains blood from the kidney.

  • Tumor.

  • Autoimmune disease.

  • Obstruction between the kidney and the ureter. The ureter is the tube that drains urine from the kidney to the bladder.

  • Infection.

  • Conditions or treatments that cause a buildup of uric acid, such as gout or cancer treatments.

  • Exposure or ingestion of poisons or toxic substances, such as:

  • Lead.

  • Cleaning products or solvents.

  • Fuels.

  • Medical procedures, such as a:

  • Surgery.

  • Biopsy.

  • Long-term use of pain medicines.

  • Trauma, such as a:

  • Car accident.

  • Gunshot or knife wound.

  • Severe physical blow or force to the kidney area (such as sustained through sports or violence).

SYMPTOMS

  • Abdominal pain and swelling.

  • Back pain and swelling.

  • Pain on one side of the body near the abdomen and back.

  • Blood in the urine.

  • Urinating less than usual.

  • Inability to urinate.

  • Pale skin color.

  • Feeling sick to your stomach (nauseous).

  • Throwing up (vomiting).

  • Fever.

  • Sweating.

  • Feeling tired and confused.

  • Weakness.

  • Bruising in the back area.

Chronic symptoms may include:

  • Constipation.

  • Irritability.

  • Weight loss.

DIAGNOSIS

Diagnosis is made by:

  • Physical exam and patient history.

  • Blood tests.

  • Urine tests.

  • Imaging tests, such as X-rays, CT scans, an ultrasound, or an MRI.

TREATMENT

A limited activity schedule or bed rest for several days may be all that is needed for mild injury. Other treatments may include the use of medicines to relieve pain, monitoring by a caregiver, or specific dietary changes.

Treatment for severe kidney injury is aimed at treating the acute symptoms and the cause of the injury. Removal of toxins from the blood (dialysis) may be required in some cases. Medicines may be given to treat the damage caused by exposure to poisons or to treat other conditions (such as gout). Certain medicines or substances that caused the injury will need to be avoided. Oral or intravenous (IV) nutritional support may also be necessary.

In some cases, surgery is needed to repair the damage and to restore kidney function. Surgery may involve: 

  • Repair of a torn (fractured) kidney.

  • Removal of an obstruction.

  • Removal of the entire kidney.

  • Drainage of fluid or blood.

  • Cessation of bleeding.

PREVENTION

To prevent kidney injuries, be sure to:

  • Manage chronic conditions, such as diabetes, high blood pressure, high cholesterol, or gout.

  • Understand your medicines and their possible side effects.

  • Stay well hydrated. Drink enough water and fluids to keep your urine clear or pale yellow.

  • Avoid exposure to lead (found in paints and metals).

  • Use cleaning products and other solvents in well-ventilated areas.

  • Always wear a seat belt when riding in a car.

  • Use proper protective equipment when participating in sports.

  • Avoid harm or violence.

SEEK MEDICAL CARE IF:

  • You are feeling ill or have severe pain in the back or side.

  • You have signs of infection (fever, feeling confused).

  • You notice blood in your urine.

SEEK IMMEDIATE MEDICAL CARE IF:

  • The amount of urine you produce has noticeably decreased or increased.

  • You develop shortness of breath even without exertion.

  • You experience unexplained weakness and fatigue.