0
Injury to the kidney and ureter is damage to these organs of the upper urinary tract.
Alternative NamesKidney 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 factorsThe 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:
- Aneurysm
- Arterial blockage
- Arteriovenous fistula
- Renal vein thrombosis (clotting)
Kidney injuries may also be caused by:
- A non-cancerous tumor (angiomyolipoma)
- Autoimmune disorders
- Excess build-up 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)
- Swelling and irritation (inflammation) caused by immune responses to medications, infection, or other disorders
- Medical procedures such as kidney biopsy, or nephrostomy tube placement
- Ureteropelvic junction obstruction
The ureters are the tubes that carry urine from the kidneys to the bladder. Uretral injuries may be caused by:
- Complications from medical procedures
- Diseases such as retroperitoneal fibrosis, retroperitoneal sarcomas, or cancers that spread to the lymph nodes
- Radiation or chemotherapy
- Trauma
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
Chronicsymptoms:
- 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 testsThe 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
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
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- Acute kidney failure, one or both kidneys
- Bleeding (may be minor or severe)
- Bruising of the kidney
- Chronic kidney failure, one or both kidneys
- Infection (peritonitis, sepsis)
- Pain
- Renal artery stenosis
- Renal hypertension
- Shock
- Urinary tract infection
Call your health care provider if you have symptoms of an injury to the kidney or ureter, especially if you have a history of:
- Exposure to toxic substances
- Illness
- Infection
- Physical injury
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.
PreventionYou 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.
Molitoris BA. Acute Kidney Injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 121.
What else can I help you with?
What part carries waste from the kidney to the bladder?
The ureter.
What is the inner layer of the kidney that leads to the ureter?
The inner layer of the kidney that leads to the ureter is called the renal pelvis. It collects urine from the kidney's collecting ducts and funnels it into the ureter, which carries the urine to the bladder for storage.
The ------ is found between the kidney and the urinary bladder?
The ureter is found between the kidney and the urinary bladder. It is responsible for carrying urine from the kidney to the bladder.
What kidney structure empties into the ureter?
The renal pelvis is the structure in the kidney that empties into the ureter. It collects urine from the calyces and funnels it into the ureter for transport to the bladder.
Does the ureter expand as a renal pyramid inside the kidney?
The ureter expands within the kidney to collect urine filtered by the neprhons. The renal pyramid is not made up of the ureter.
Which part of the kidney is an expansion of the upper end of a ureter?
The ureter joins the kidney at an area called the renal pelvis.The renal Pelvis
What is the notch through which ureter leaves the kidney?
The notch through which the ureter leaves the kidney is called the renal hilum. It is the medial depression where the renal artery, renal vein, and ureter enter and exit the kidney.
To what organ does the ureter lead from the kidney?
The ureter leads to the bladder where urine is stored until it is voided.
Which organ takes urine out of the kidney?
The ureter leads urine out of the kidney and into the bladder.
Where does Kidney stones tend to get trapped in?
Kidney stones tend to get trapped in the ureter leading out of a kidney into the bladder.
What is the function of ureter (from the kidney)?
Ureters carry urine form the kidney to the bladder (one from each kidney).
What tubelike structure connects the kidney to the bladder?
Ureter. The urethra connects the bladder to the outside world.
