Kidney Swelling: Causes, Symptoms, and Next Steps

Q: Kidney Swelling: Causes, Symptoms, and Next Steps

Hello： Generally, if there are no severe symptoms, observation for a few weeks is advisable, as small stones have a high likelihood of passing on their own. <br>Personally, if there is still swelling after 2-3 weeks, I recommend performing a renal pelvis imaging study to locate t

Low back pain due to renal edema?

On the evening of August 26, I woke up with back pain less than 10 minutes after preparing for bed.
I went to the bathroom several times, and since I had a kidney stone experience over a decade ago, I immediately suspected an issue with my right kidney.
I went to the emergency room in the early morning and the doctor performed a urinalysis which showed trace blood, as well as an X-ray.
I was given pain relief and anti-inflammatory medication and sent home.

The next morning, I visited a urologist who conducted an ultrasound and noted that my right kidney was swollen.
The X-ray showed a prominent white spot, which the doctor suggested might be a stone, and prescribed antibiotics for me to take at home.
On September 7, I returned for a follow-up appointment and another X-ray showed that the kidney was still swollen, but slightly smaller than before.
The doctor diagnosed me with hydronephrosis and mentioned that the previous X-ray did not clearly indicate where the problem was.
Urinalysis results were normal.

Currently, I occasionally feel a dull ache or sharp pain in the area of my right kidney.
Since no specific issues have been identified other than hydronephrosis, the doctor advised against prescribing medication for now.
What should I do next? Thank you.

Xiao Chen, 40~49 year old female. Ask Date: 2017/09/07

Dr. Du Shixi reply Urology

Hello: Generally, if there are no severe symptoms, observation for a few weeks is advisable, as small stones have a high likelihood of passing on their own.
Personally, if there is still swelling after 2-3 weeks, I recommend performing a renal pelvis imaging study to locate the stones causing the hydronephrosis, in order to determine if intervention is necessary.
In the meantime, it is important to drink plenty of water, maintain a light diet, and stay active to facilitate stone passage.
If symptoms arise, medication should be taken.
Wishing you good health.
(The key point is that regardless of symptoms, it is essential to confirm that the hydronephrosis has resolved before discontinuing follow-up.)

Reply Date: 2017/09/07

More Info

Understanding kidney swelling, or renal swelling, is crucial for identifying underlying issues and determining appropriate next steps. Based on your description, it appears that you have experienced a series of symptoms and diagnostic evaluations that suggest renal swelling, possibly due to a kidney stone or other obstructive process.

Causes of Kidney Swelling
Kidney swelling can occur for several reasons, including:
1. Obstruction: This is often caused by kidney stones, which can block the flow of urine and lead to hydronephrosis (swelling of the kidney due to urine buildup). Your history of kidney stones makes this a likely cause.

2. Infection: Urinary tract infections (UTIs) can lead to swelling if they cause inflammation or if they result in an obstruction.

3. Trauma: Any injury to the kidney area can lead to swelling.

4. Tumors or Cysts: Abnormal growths can also cause swelling, though these are less common.

5. Systemic Conditions: Conditions like diabetes or hypertension can affect kidney function and lead to swelling.

Symptoms
The symptoms of kidney swelling can vary but often include:
- Pain in the back or side (flank pain)
- Changes in urination patterns (frequency, urgency, or blood in urine)
- Nausea or vomiting
- Fever (if infection is present)
- Swelling in the abdomen
In your case, the intermittent pain and the ultrasound findings of kidney swelling suggest that there is an ongoing issue that needs to be monitored.

Next Steps
Given your situation, here are some recommended next steps:
1. Follow-Up Appointments: Continue to follow up with your urologist. Regular monitoring is essential, especially since your kidney is still swollen. Your doctor may recommend periodic imaging studies (like ultrasound or CT scans) to assess changes in the kidney's condition.

2. Pain Management: If you experience pain, discuss pain management options with your doctor. Over-the-counter pain relievers may help, but it’s important to consult your physician before taking any medication.

3. Hydration: Staying well-hydrated can help flush out any potential stones and reduce the risk of further obstruction. However, if you have any restrictions on fluid intake due to other health conditions, consult your doctor.

4. Dietary Adjustments: Depending on the cause of your kidney swelling, dietary changes may be beneficial. For instance, if kidney stones are a concern, reducing sodium and oxalate-rich foods may help.

5. Monitoring Symptoms: Keep a close watch on your symptoms. If you experience worsening pain, fever, or changes in urination, seek medical attention promptly.

6. Consider Additional Testing: If your symptoms persist or worsen, your doctor may recommend further testing to rule out other causes of kidney swelling, such as a CT scan or MRI.

7. Consult a Nephrologist: If your urologist feels it is necessary, they may refer you to a nephrologist (a kidney specialist) for further evaluation and management.

Conclusion
Kidney swelling can be a sign of various underlying issues, and it’s essential to work closely with your healthcare provider to monitor your condition. Given your history of kidney stones and the current findings, it’s crucial to stay vigilant and proactive in managing your kidney health. Regular follow-ups, symptom monitoring, and lifestyle adjustments can significantly contribute to your overall well-being and kidney function. If you have any concerns or questions, don’t hesitate to reach out to your healthcare provider for guidance.

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