Injury - kidney and ureter Health Article

Symptoms

Acute or emergency symptoms may include:

• Abdominal pain
• Abdominal swelling
• Back pain
• Blood in the urine
• Decreased alertness
  • Coma
  • Drowsiness, lethargy
• Decreased urine output
• Fever
• Flank pain, severe
• Increased heart rate
• Inability to urinate
• Nausea, vomiting
• Pale skin
• Skin cool to touch
• Sweating

Chronic symptoms:

• Constipation (with toxic injury, lead poisoning)
• Irritability
• Weight loss

If only one kidney is affected, there may be no symptoms, because the second (healthy) kidney functions well enough for normal health.

Signs and tests

The health care provider may find the source of the injury by looking at your:

• History of physical injury
• Exposure to toxic substances
• Recent infections or illness

Signs may include:

• Excess bleeding (hemorrhage)
• Extreme tenderness over the kidney
• Shock, including rapid heart rate or falling blood pressure
• Signs of kidney failure

Tests that may be done include:

• Abdominal CT scan
• Abdominal MRI
• Angiography of the kidney artery or vein
• Blood electrolytes
• Blood tests to look for toxic substances
• Complete blood count (CBC)
• Intravenous pyelogram (IVP)
• Kidney x-ray
• Renal scan
• Urinalysis

Treatment

The goals are to treat emergency symptoms and prevent or treat complications. You may need to stay in a hospital for close observation because of the risk of internal blood loss from an injured kidney.

Nonsurgical treatments for kidney injury may include:

• Analgesics for pain relief
• Bed rest for 1 - 2 weeks or until bleeding is reduced
• Close observation and treatment for symptoms of kidney failure
• Dietary restrictions
• Medications to treat damage caused by toxic substances or illnesses (for example, chelation therapy for lead poisoning or allopurinol to lower uric acid in the blood from gout)
• Stopping medications or exposure to substances that might have injured the kidney
• Medications such as corticosteroids or immunosuppressants if the injury was caused by infection or inflammation
• Treatment of acute kidney failure

Surgical treatments for kidney injury may include:

• Surgery to repair a "fractured" or torn kidney, torn blood vessels, torn ureter, or similar injury
• Surgery to remove the entire kidney (nephrectomy), drain the space around the kidney, or stop the bleeding (angio-embolization)

Treatments for ureter injury may include:

• Surgery to remove or repair clots or other blockages