How can you tell if your kidneys are swollen?

Kidney swelling, also known as nephromegaly, is a condition where one or both kidneys become enlarged. This can be caused by a number of different medical issues, ranging from relatively benign to potentially life-threatening. Detecting kidney swelling early is important, as it allows for prompt treatment to address the underlying cause. But how can you tell if your kidneys are swollen in the first place?

What are the kidneys and what do they do?

The kidneys are a pair of bean-shaped organs located in the back of the abdomen, with one on each side of the spine. They play several important roles in the body:

  • Filtering waste products and excess fluid from the blood to produce urine
  • Regulating levels of electrolytes like sodium, potassium, and phosphate
  • Releasing hormones that regulate blood pressure and red blood cell production
  • Activating vitamin D for bone health

Each day, the kidneys filter about 120-150 quarts of blood to remove waste and extra fluid. The waste combines with water to become urine, which travels from the kidneys to the bladder through tubes called ureters. The bladder stores urine until it exits the body through the urethra when you urinate.

What causes the kidneys to become swollen?

There are several possible causes of enlarged kidneys, including:

  • Kidney infections – Bacterial infections of the kidney, called pyelonephritis, can cause swelling along with pain, fever, and other symptoms.
  • Kidney stones – Hard deposits of minerals and acid salts that form inside the kidneys can block urine flow and cause swelling and pain.
  • Kidney cysts – Fluid-filled sacs that form in the kidneys, which may gradually enlarge the kidneys if multiple cysts develop.
  • Hydronephrosis – Swelling caused by a backup of urine in the kidney due to an obstruction like a kidney stone or enlarged prostate.
  • Glomerulonephritis – Inflammation of the glomeruli (filtration units) inside the kidneys, hampering their ability to filter blood.
  • Pyelonephritis – Inflammation caused by a kidney infection.
  • Polycystic kidney disease – An inherited disorder where cysts form and grow progressively larger over time.
  • Interstitial nephritis – Inflammation of the kidney tissues due to an autoimmune disorder, antibiotic side effect, or toxin.
  • Diabetic nephropathy – Kidney damage occurring in people with poorly controlled diabetes.
  • Hypertensive nephropathy – Damage to the small blood vessels in the kidneys due to high blood pressure.
  • Vesicoureteral reflux – Urine backs up from the bladder into the ureters and kidneys, causing swelling.
  • Nephrotic syndrome – Disorders that cause the kidneys to leak large amounts of protein into the urine.
  • Wilms’ tumor – A rare kidney cancer that primarily affects children.
  • Lymphoma – Swelling may occur if lymph tissues around the kidneys become affected by cancers like lymphoma.
  • Leukemia – Blood cancers that infiltrate the kidneys can cause them to enlarge.

In most cases, treating the underlying condition will resolve the kidney swelling. But prompt diagnosis is important, as some of these disorders can lead to permanent kidney damage if left unchecked.

What are the most common symptoms of swollen kidneys?

Enlarged kidneys may not cause any noticeable symptoms at first. But as the swelling increases, the following symptoms could develop:

  • Flank pain – Pain or tenderness in your side or back below your ribs, where your kidneys are located.
  • Abdominal pain – Pain in your abdomen around where your kidneys are located, which may radiate to other areas.
  • Changes in urination – Need to urinate more or less frequently, pain or burning during urination, or cloudy, bloody, or strong-smelling urine.
  • Nausea and vomiting – Kidney swelling can sometimes irritate the digestive tract.
  • Fatigue – Impaired kidney function may lead to waste buildup in the blood, causing tiredness.
  • Swelling in legs or ankles – Accumulation of fluid due to impaired kidney filtration.
  • High blood pressure – Kidneys help regulate blood pressure, so damage can cause hypertension.

Keep in mind that other conditions like pulled muscles, digestive issues, or urinary tract infections can also cause these types of symptoms. The symptoms alone do not necessarily mean your kidneys are swollen. That’s why it’s important to see a doctor for an evaluation if you have persistent abdominal or urinary symptoms.

How do doctors diagnose swollen kidneys?

If kidney swelling is suspected based on your symptoms and medical history, your doctor will likely order some tests to confirm it and determine the cause, including:

  • Blood tests – To check kidney function and look for any abnormalities with your blood cells or electrolyte levels that could indicate a kidney problem.
  • Urinalysis – Checking your urine sample under a microscope for blood, protein, or other signs of kidney disease.
  • Imaging tests – Ultrasound, CT scan, or MRI to get a view of the size and structure of your kidneys.
  • Kidney biopsy – Removing a small sample of kidney tissue to examine under a microscope, which can help identify specific diseases.

Based on your test results and overall health, your doctor will determine the likely cause and decide on appropriate treatment. Getting an accurate diagnosis is very important, as many conditions that cause swollen kidneys require specific treatments.

Can swollen kidneys be treated?

Whether swollen kidneys can be treated successfully depends on the underlying condition causing it. Here are some examples of potential treatments:

  • Infections – Antibiotics to clear bacterial kidney infections and reduce swelling.
  • Kidney stones – Some stones pass on their own, while larger ones may require lithotripsy to break them up or surgical removal. Stents may temporarily relieve obstruction.
  • Kidney cysts – Drainage or surgical removal if the cysts are large or causing symptoms. Medications can slow cyst growth in polycystic kidney disease.
  • Hydronephrosis – Surgery may be done to remove obstructions if present. Drainage tubes can provide temporary relief.
  • Glomerulonephritis – Immune-suppressing medications to reduce inflammation and prevent further kidney damage.
  • Urinary blockage – Surgery, drainage tubes, or medications can open up the urinary tract and allow urine to flow freely again.
  • Kidney cancer – Surgical removal of cancerous kidney tissue, sometimes coupled with chemotherapy or radiation therapy.

If the swelling was caught early and treated promptly, the kidneys can often recover fully. But some kidney diseases like polycystic kidney disease may eventually progress to kidney failure if the swelling becomes severe. At that point, dialysis or a kidney transplant may be necessary.

Can kidney swelling be prevented?

There are some precautions you can take to lower your chances of developing conditions that could potentially lead to swollen kidneys:

  • Drink plenty of fluids to stay well hydrated.
  • Control conditions like high blood pressure and diabetes through medications and lifestyle changes.
  • Get regular medical checkups to monitor kidney function.
  • Avoid overuse of medications that can harm the kidneys, like NSAIDs.
  • Prevent and treat urinary tract infections promptly.
  • Avoid toxin exposure from heavy metals, pesticides, or other hazardous substances.
  • Manage health conditions that increase kidney infection risk, like kidney stones, vesicoureteral reflux, or enlarged prostate.
  • If you have polycystic kidney disease or another genetic kidney disorder in your family, get screened.

While not always preventable, being proactive with your health and medical care can lower your risk of developing swollen kidneys.

When to see a doctor

Make an appointment with your doctor promptly if you notice any of the following:

  • Persistent flank pain, abdominal pain, or pain with urination
  • Fever over 101°F (38.3°C), which could signal an infection
  • Blood in your urine
  • Nausea, vomiting, or diarrhea that lasts over 24 hours
  • Swelling in your legs or feet
  • Increased fatigue, weakness, or confusion
  • Difficulty urinating or decrease in urine output
  • High blood pressure that remains elevated above normal

While many conditions can cause these types of symptoms, prompt medical evaluation is important to determine if kidney swelling or damage could be responsible. Timely treatment can prevent the problem from worsening.

When to seek emergency care

Seek emergency medical care right away if you experience:

  • Sudden, severe flank or abdominal pain, especially if accompanied by nausea and vomiting – this could indicate a kidney obstruction or rupture
  • Fever over 103°F (39.4°C)
  • Difficulty breathing or chest pain – kidney swelling can cause fluid in the lungs in some cases
  • Severe swelling in your legs, ankles, or feet that develops rapidly
  • Profuse sweating, muscle cramps, twitching, or seizures – may be signs of electrolyte imbalances
  • Confusion, drowsiness, weakness, or impaired vision – indicates possible uremic poisoning if kidneys stop filtering blood adequately
  • Decrease in urine output such that you aren’t urinating at all for 6-8 hours

These types of symptoms suggest your kidneys may not be functioning properly and immediate treatment is needed. Swelling is just one symptom of many possible with kidney disease, so pay attention to any unusual changes in your health.

Living with swollen kidneys

If your kidney swelling is due to an ongoing medical condition, like polycystic kidney disease or chronic kidney infection, you will need to take steps to support your kidney health and prevent further damage. Work with your doctor to create a treatment plan that may involve some of the following:

  • Taking medications as prescribed to control your kidney disease and manage related complications like high blood pressure
  • Following a kidney-friendly diet, usually limiting sodium, potassium, phosphorus, and protein intake
  • Getting regular blood and urine tests to monitor your kidney function
  • Undergoing dialysis if your kidneys can no longer adequately filter your blood
  • Seeing specialists like a urologist or nephrologist for kidney care
  • Staying physically active but avoiding contact sports that could injure your kidneys
  • Drinking plenty of fluids daily but avoiding alcohol and caffeinated beverages
  • Quitting smoking and avoiding secondhand smoke
  • Taking steps to manage stress levels, fatigue, and other effects on your quality of life

Living with chronic kidney disease can be challenging but is very possible by actively managing your health. Stay in close communication with your healthcare providers and be vigilant about your treatment plan and lifestyle habits.

Takeaways

  • Kidney swelling has several potential causes, including infections, kidney stones, cysts, cancer, or urinary blockages.
  • Symptoms may include flank pain, abdominal pain, changes in urination, nausea, fatigue, or high blood pressure.
  • Diagnosis is made through blood and urine tests, imaging tests like ultrasound or CT scan, and sometimes kidney biopsy.
  • Treatment depends on the underlying cause but may include medications, surgery, electrolyte management, or dialysis.
  • Kidney health can be supported through lifestyle measures like staying hydrated, controlling blood pressure, and avoiding toxins.
  • Seek prompt medical attention for persistent kidney-related symptoms or any signs of new kidney problems.

Swollen kidneys should never be ignored, as timely treatment can prevent permanent damage in many cases. Stay attuned to your body and speak with your doctor if you suspect any kidney issues.

Conclusion

Monitoring the health and function of your kidneys is important. Swelling or enlargement of one or both kidneys can be the result of several disease processes ranging from relatively benign to potentially life threatening. If you notice any symptoms such as flank pain, changes in urination, high blood pressure, fatigue or nausea/vomiting, do not delay seeking medical attention. Your doctor can order tests to determine if your kidneys are swollen and if so, diagnose the cause. Treatment will focus on the underlying disease. Aggressive management of kidney swelling is often key to preserving as much kidney function as possible. While kidney damage cannot always be avoided, familiarizing yourself with the signs of trouble allows you to get medical help promptly when needed.

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