Associated symptoms

The position of the kidneys is often not correctly interpreted by those affected, so it happens that kidney pain is described, but the pain continues deeper, namely in the area of the spine. In adults, the kidneys spread out about 25-30 cm above the pelvis, approximately on the same side. If it is a kidney disease, usually only one kidney is affected at first, so that a symmetrically indicated pain would be unusual, but not impossible.

On the other hand, unilateral pain along the spinal column downwards can very well indicate a disease of the kidney and the urinary tract. Especially if the pain is one-sided and extends forward around the flank and ends at the level of the bladder, the urinary diversion system should be shortlisted as the cause. If the kidneys or the urinary diversion system are affected, the pain may also radiate and initially indicate another organ that is diseased.

Kidney problems can therefore be associated with pain of a different localization.The kidneys are connected on both sides with the bladder via the ureter. This ensures that the urine filtered in the kidney is safely transferred to the storage reservoir – the bladder. The ureters pull forward from the renal pelvis of the kidney on both sides of the trunk at an angle.

At the back wall of the bladder the ureters enter the bladder from the left and right. On their way from the renal pelvis of both kidneys the ureters cross the lateral edge of the abdominal cavity. Common diseases, especially in women, are urinary tract infections that originate in the urethra and can then rise.

On the ascending path, the infection reaches the urinary bladder – an inflammation of the bladder occurs. If no treatment is given, the ureters are usually affected on one or both sides. When a urinary tract infection begins, patients usually only complain of a burning sensation when urinating and a so-called pollakiuria – a frequent urge to urinate without sufficient quantity of urine.

If the infection reaches the bladder, patients experience painful urination and painful pressure at the level of the bladder. These complaints can easily be dismissed as abdominal pain. During the examination, the abdomen just above the bladder is also often painful due to pressure.

This is due to the projection of the pain from the bladder upwards. If the urinary tract infection rises further upwards and reaches the ureters, it travels a not inconsiderable distance through parts of the abdomen. At all stations along the ureters, an ascending urinary tract infection can cause pressing or pulling pain, which is described as abdominal pain and can sometimes be some due to the corresponding projection of the nerves.

Ureteral stones are also relatively common. They usually originate in one of the kidneys. This is where classic, mostly unilateral pain of the kidneys occurs.

Kidney stones can become detached and then enter the ureter through the renal pelvis. Via the ureter they migrate downwards towards the bladder and can cause pain all the way down. This pain results from irritation of the ureters when the kidney stone gets stuck to the wall.

The pain is therefore often described as stabbing back or flank pain. If the stone gets into the bladder, it usually does not cause such severe pain. However, a feeling of pressure in the stomach is often described.

On its way down it can also always cause severe colic in the area of the flank and abdomen. This colic results from the stone getting caught in the thin ureters. Especially in cases of colicky pain in the area of the ureters caused by small kidney stones, it is possible that, in addition to the severe abdominal pain, accompanying symptoms are also reported by the patients.

In the case of severe colic, the patient is usually in extremely bad shape. Due to the strong pain, which occurs in waves, nausea or even vomiting usually occurs reflexively. In the case of colic pain, a level of pain never experienced before is often indicated.

A fever usually does not occur with renal colic. If kidney or abdominal pain occurs in connection with fever, an infectious cause should always be considered. As a rule, urinary tract infections are on the shortlist.

In the presence of fever, however, it is either a severe urinary tract infection that has not been treated for a long time or a high-rising urinary tract infection that has reached the renal pelvis. This is also known as inflammation of the renal pelvis (pyelonephritis). This is a serious complication of urinary tract infection.

Patients often have high fever, severe nausea and vomiting. The general condition is usually extremely poor, and a quick therapeutic procedure is urgently needed. The differential diagnosis of nausea and fever in combination with abdominal pain should always include a gastrointestinal cause.

In this case, gallbladder inflammation, pancreatitis or biliary colic would be the most common. Biliary colic is similar to renal colic. A gallstone has grown in the gallbladder and now forces its way through the narrow bile duct system.

Whenever it gets caught on a wall of the bile duct, it causes extremely severe pain in the abdominal area. This biliary colic can also be accompanied by nausea and vomiting. High fever, on the other hand, often occurs only in the case of inflammation of the gall bladder or bile ducts.The final diagnosis and differentiation should be clarified by ultrasound examination of the kidneys and gastrointestinal system.

Laboratory tests of the blood also provide information about the cause of the symptoms. It is true that patients sometimes report diarrhea in addition to nausea, fever and vomiting in cases of urological diseases or kidney disorders. However, this occurs more frequently in the case of infections of the gastrointestinal tract.

If the bile ducts are obstructed by a stone or a severe inflammation of the bile ducts or gallbladder, it can happen that the bile acids necessary for digestion no longer reach the intestine in the quantity as usual. This may lead to incomplete digestion, which the patient feels through mushy stools or watery diarrhea. If all symptoms (kidney pain, abdominal pain, nausea, vomiting and fever) occur, a general flu-like infection should also be considered. Here no individual organ is affected, but rather the weakening of the organism by the virus is to blame for the symptoms.