The kidneys are bean-shaped organs that are located against the back muscles in the upper abdominal area. They sit opposite to each other on both sides of the body; the right kidney, however, sits a little lower than the left to accommodate the size of the liver.
Kidneys are located inside the lower abdomen, on each side of your spine. Pain on the sides or middle to upper back could be coming from kidneys. However, having pain in your back or sides does not necessarily mean there is something wrong with your kidneys. It is possible to have pain on only one side if only one kidney has a problem, or both sides if both kidneys are affected.
Signs & Symptoms
- fever
- painful urination
- flank pain
- pain on the back and abdomen. (Kidney pain can be on the left, right, or both sides.)
- Blood in urine
- Nausea & vomiting
- Dizziness
- Constipation or diarrhoea
- Rash
- Stanchezza
- Kidney pain or flank pain which is acute, relatively constant, and sharp, called as “renal colic.” This happens due to a kidney stone.
If the kidney function is increasingly compromised, there will be:
- Metallic taste in mouth,
- Bad breath,
- swelling and shortness of breath.
Cause
- Infezioni delle vie urinarie
- trauma that can result in a “lacerated kidney.”
- Urinary bladder infection(cystitis)
- Kidney infections (pyelonephritis)
- Hydronephrosis
- Kidney stones (nephrolithiasis and/or ureterolithiasis)
- Carcinoma of kidney
- Anything that compresses the kidney (for example, a large tumour or cyst)
- Glomerulonephritis
- Blood clots in the kidneys (renal vein thrombosis)
- Polycystic kidney disease (congenital)
- Congenital malformations in the renal system
- Drugs or toxins that harm kidney tissue (for example, pesticide exposure or chronic use of medications such as ibuprofen)
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Fisiopatologia
Pathophysiology solely depends upon the cause of kidney pain.
Coming to kidney pain pathophysiology, obstruction happens first, most commonly from a stone. But blood clots can also be the cause.
Urine is unable to travel from kidney to the bladder and as a result builds up and stretches the proximal – closest to the kidney – ureter and renal collecting system. This stretch activates nociceptive nerve fibres within an entire neuronal network located submucosally in the renal pelvis, calyces, capsule and ureter.
These fibres then transmit afferent signals to the T11 – L1 spinal cord which the body interprets as pain at the corresponding level of neuronal activation. As the stone migrates from the kidney down the ureter and towards the bladder, pain usually shifts downward as well. It is commonly sensed as high as the upper flank when the stone is lodged in the proximal ureter and as low as the labia/testicle when down near the uretero-vesical junction at the entry to the bladder.
Patients passing stones may experience other symptoms in addition to pain. Many of the nerves involved in the process of obstruction are intimately linked to innervation of adjacent organs, for example the gastrointestinal tract. Cross activation of these associated nerve fibres has been proposed as an explanation for the nausea and vomiting which so often occurs in the setting of an acute episode of renal colic.
In rare instances patients may even have alternative symptoms without any pain at all. In some cases, particularly when the stone is at the uretero-vesical junction, urinary symptoms predominate and the only appreciable symptoms are urinary frequency, urgency and discomfort while voiding. These symptoms mimic urinary infection and often result in temporary mis-treatment with antibiotics until the correct diagnosis is made.
Diagnosi
- Physical examination and history taking
- Complete Blood Count (CBC),
- Renal function test
- Urine examination and cultures.
- TAC
- Renal Ultrasound
- Abdominal X-ray
- RISONANZA MAGNETICA
Kidney pain itself is a symptom that may happen due to problems or diseases of the kidney or its associated structures, including the ureters or bladder. However, other diseases may mimic kidney pain, but are not actually due to the kidneys, for example,
- muscle sprains, especially in the back,
- spinal problems,
- rib pain,
- pleuritis
- retroperitoneal fibrosis,
- aortic abdominal aneurysm,
- gynaecological problems like PCOD, endometriosis etc
Trattamenti
The treatment for kidney pain depends on the cause.
- Kidney infections and kidney stones that cause pain are often treated with ibuprofen, ketorolac (Toradol), acetaminophen (Tylenol and others), or occasionally with small amounts of morphine (in severe cases). However, these agents do only pain management and do not address the cause(s) of pain.
- If small kidney stones (usually less than about 6 mm in diameter) are passed in the flow of urine, and pain will be relieved.
- Infections like urinary tract infections and pyelonephritis usually require antibiotic treatments in addition to pain medications.
- Kidney stones more than 6mm diameter, need surg.
- Other underlying causes of flank pain may need similar pain management and concurrent treatments. However, patients with known kidney problems (kidney disease) should not be treated with pain medications that are either filtered (removed) through the kidneys and/or may cause further renal damage.
Prognosi
The prognosis of kidney pain depends upon the cause, and the majority of patients can have a good outcome when treated quickly and appropriately.
Complicazioni
- Abscess formation
- Serious infection of the kidney that diminishes renal function
- Urinary fistula formation
- Ureteral scarring and stenosis
- Ureteral perforation
- Extravasation
- Urosepsis
- Renal loss due to long-standing obstruction
- Complete ureteral obstruction
Infected hydronephrosis is the deadliest complication with chance of rapidly progressive sepsis and death.
A ureteral stone associated with obstruction and upper UTI is a true urologic emergency.
Malattie e Ayurveda
Kidney pain -Pakwasayagata vaata/Mootraghata
Nidana
Diet and behaviour causing Vaata vitiation
Purvaaroopa
Non menzionato
Samprapti
Due to the causative factors including obstruction by a calculi, Vitiated vaata gets obstructed & goes into abnormal pathways causing pain.
Lakshana
- Soola – abdominal pain
- Aanaha – Distension of abdomen
- Antrakujana – Abnormal pesristaltic sounds
- Malarodha – Constipation
- Asma – Calculi in kidney/ureter/urinary bladder
- Varddha – Cysts or growths in lower abdomen, especially excretory/reproductive organs
- Arsas – Piles
- Thrika-Prishtha-Kateegraha – Pain & stiffness in coccygeal region, Lower back and hip area.
Divisioni
Non menzionato
Prognosi
- Kricchrasadhya/Yaapya
- Chikithsa
- Samana
- Abhyangam
- Pichu
- Kateevasti
- Sodhana
- Avapeedakasnehapanam
- Vastikarma
Farmaci comunemente utilizzati
Marche disponibili
- AVS Kottakal
- AVP Coimbatore
- Vaidyaratnam oushadhasala
- SNA Oushadhasala
Rimedi casalinghi
For some people who have had many kidney stones, home care may be appropriate. When passing a kidney stone, drinking lots of fluid is important. In fact, this is the most important home care measure. Medications may help control the pain temporarily.
Dieta
- Da evitare
Alimenti caldi, piccanti e pungenti
Sottaceti, prodotti masala lavorati e in scatola.
I pasti pesanti e gli alimenti difficili da digerire causano indigestione.
Cibi spazzatura: causano disturbi della digestione e riducono la biodisponibilità del farmaco.
Bevande gassate: rendono lo stomaco più acido e disturbano la digestione.
Cibi refrigerati e congelati - causano una digestione debole e lenta indebolendo Agni (fuoco digestivo).
Cagliata - causa vidaaha e quindi molte altre malattie
- Da aggiungere
Pasti leggeri e alimenti facilmente digeribili
Grammo verde, zuppe, succhi freschi, salsapariglia indiana, acqua di cocco tenera, canna da zucchero e arrowroot.
Freshly cooked and warm food processed with coriander seeds, cumin seeds, ginger, ajwain etc
Comportamento:
Bere acqua a sufficienza e urinare frequentemente.
Mantenere l'igiene personale, soprattutto delle parti intime. Evitare di usare i bagni pubblici, di usare indumenti intimi bagnati, ecc.
Proteggersi dalla disidratazione e dall'esposizione al calore.
È meglio evitare l'esposizione a luce solare eccessiva, vento, pioggia o polvere.
Mantenere un programma alimentare e di sonno regolare.
Evitare di trattenere o forzare gli stimoli come urina, feci, tosse, starnuti ecc.
lo yoga
In persons with fever, severe pain and severe urinary tract infections, physical exercises are not recommended.
L'esercizio fisico regolare dopo aver riacquistato una salute normale aiuta a migliorare la biodisponibilità degli alimenti ingeriti e porta a una salute positiva.
Nadisudhi pranayama
Tutti gli esercizi e gli sforzi fisici devono essere decisi ed eseguiti esclusivamente sotto la supervisione di un medico esperto.
Research Articles
https://www.ncbi.nlm.nih.gov/books/NBK292/
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