Injury of the kidney and ureter

Alternative names:

bruised kidney; fractured kidney; inflammatory injury of the kidney; kidney damage; kidney injury; toxic injury of the kidney; traumatic injury of the kidney

Definition:

Damage to the structure of the kidney and/or ureter

Causes, incidence, and risk factors:

The kidneys are located in the back of the upper abdomen at either side of the spinal column. They are deep within the abdomen from the front and are protected in the back by the spine, lower rib cage, and the strong muscles of the back. This location protects them from external forces, so injury from external sources is uncommon. However, it may occur with athletic injury, occupational injury, or from traumatic accidents.

The kidneys are highly vascular organs. They may be injured from damage to the blood vessels that supply or drain them, such as may occur with arterial occlusion or renal vein thrombosis. Kidneys may also bleed profusely if they are damaged. The most common result of kidney injury from external force is bruising of the kidney, which is self contained and heals spontaneously. The most dangerous result of kidney damage from external force is bleeding, which can be profuse and life threatening.

Each kidney filters about 1700 liters of blood per day and concentrates fluid and waste products into about 1 liter of urine per day. Because of this, the kidneys receive more exposure to toxic substances in the body than almost any other organ; therefore, they are highly susceptible to injury from toxic substances. Analgesic nephropathy is one of the most common types of toxic damage to the kidney. Exposure to lead, cleaning products, solvents, fuels, or other nephrotoxic chemicals (those which can be toxic to the kidney) can damage kidneys. Excessive build-up of body waste products such as uric acid (that can occur with gout or with treatment of bone marrow, lymph node, or other disorders) can also damage the kidneys.

Inflammation from immune response to medications, infection, or disorders may also injure the structures of the kidney, usually causing various types of glomerulonephritis or acute tubular necrosis (tissue death).

Injury to the kidney may result in short-term damage with minimal or no symptoms. It may also be life threatening from bleeding and associated shock, or it may result in acute renal failure or chronic renal failure.