Injury - Kidney And Ureter
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Definition
Injury to the kidney and ureter is damage to these organs of the upper urinary tract.
Alternative Names
Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury
Causes, incidence, and risk factors
The kidneys are located in the flank (back of the upper abdomen at either side of the spinal column). They are deep in the abdomen and are protected by the spine, lower rib cage, and strong muscles of the back. This location protects the kidneys from many outside forces.
The kidneys are well-padded for a reason -- they have a large blood supply. Injury can lead to severe bleeding.
Kidneys may be injured by damage to the blood vessels that supply or drain them, including:
Kidney injuries may also be caused by:
Angiomyolipoma, a noncancerous tumor
Bladder outlet obstruction
Cancer of the kidney, pelvis, or colon
Diabetes, high blood pressure, or other medical conditions that affect the kidneys
Excess buildup of body waste products such as uric acid (which can occur with
gout or treatment of bone marrow, lymph node, or other disorders)
Exposure to toxic substances such as lead, cleaning products, solvents, fuels, or long-term use of high-dose pain medications (
analgesic nephropathy)
Inflammation caused by immune responses to medications, infection, or other disorders
Medical procedures such as
kidney biopsy, or nephrostomy tube placement
Ureteral obstruction
The ureters are the tubes that carry urine from the kidneys to the bladder. Uretral injuries may be caused by:
References
Molitoris BA. Acute kidney injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 121.
Review Date: 9/3/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury
Symptoms
Acute or emergency symptoms may include:
Long-term (chronic) symptoms may include:
If only one kidney is affected and the other kidney is healthy, you may not have any symptoms.
Signs and tests
The health care provider may find the source of the injury by reviewing your:
History of physical injury
Exposure to toxic substances
Recent infections or illness
A physical exam may reveal:
Tests that may be done include:
References
Molitoris BA. Acute kidney injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 121.
Review Date: 9/3/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury
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 due to gout)
- Stopping medications or exposure to substances that may have injured the kidney
- Medications such as corticosteroids or immunosuppressants if the injury was caused by inflammation
- Treatment of acute kidney failure
Surgical treatments for kidney injury may include:
Surgery may be needed to treat a ureter injury.
Expectations (prognosis)
The outcome depends on the cause and extent of injury. The damage may be mild and reversible, immediately life-threatening, or long-term and causing complications.
The kidney may return to normal function, or it may go into acute or chronic failure.
Complications
Calling your health care provider
Call your health care provider if you have symptoms of an injury to the kidney or ureter, especially if you have a history of:
Go to the emergency room or call the local emergency number (such as 911) if you have decreased urine output after a kidney injury. This may be a symptom of kidney failure.
References
Molitoris BA. Acute kidney injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 121.
Review Date: 9/3/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury
Prevention
You can help prevent injury to the kidneys and ureter by following these precautions:
Be aware of possible sources of lead poisoning, such as old paints, vapors from working with lead-coated metals, and alcohol distilled in recycled car radiators.
- Follow your health care provider's directions for using all medications, including over-the-counter medications.
- Follow your health care provider's instructions for treating gout and other illnesses.
- Use appropriate safety equipment during work and play.
Use cleaning products, solvents, and fuels as directed in a well-ventilated area because the fumes may also be toxic.
Wear seat belts and drive safely.
References
Molitoris BA. Acute kidney injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 121.
Review Date: 9/3/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 9/3/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.