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Forum Name: Nephrology Symptoms

Question: Kidney Problems


 miclus - Mon Dec 25, 2006 5:15 pm

Hi. I'm not able to get in to a kidney specialist here because I need a referral and some test that shows something wrong. Basically, I have a lot of pain near my right kidney area and ribs and seems to radiate into my groin and buttock. I've had Abdominal CT and Abdominal US and some urine studies and blood work for kidney function. They have all been normal. I am a 25 year old white male. Based on this info, what would be the likelihood I still have a kidney problem?
 Dr. Chan Lowe - Mon Dec 25, 2006 6:52 pm

User avatar You may consider doing a 24 hour urine test for urine calcium. Hypercalciuria (too much calcium in the urine) can still cause pain, even though there are no overt kidney stones. Also, did they do the CT scan with contrast specifically looking for kidney stones? A general abdominal CT may miss renal stones.

When you refer to blood tests, does this include calcium? Hypercalcemia can cause abdominal pain, among other things including things unrelated to the kidneys. Can you describe the pain in a little more detail? I.e. how long it lasts, is it stabbing pain or more of a dull ache, how often it occurs, etc? This may be helpful to give you a bit better information as to how to proceed.

As always, follow up with your doctor is important as the internet is no substitute for direct evaluation.

Merry Christmas. Keep us updated.
 miclus - Mon Dec 25, 2006 11:55 pm

Hi. Thanks for writing. They did an Abdominal CT first without contrast, and then an abdominal ultrasound. I don't think they were looking for anything specific though. The second Abdominal CT added oral and iv contrast. Also, I forgot to mention I did an IVP. The pain I have is like a bad burning/bruised feeling to the tough near the ribs. Seems to eithe radiate down into my groin and right testicle, or actually be from my groin and right testicle area and somehow referred upwards. Basically, it's much worse when I sit or lay, but better when I'm standing. It's basically a permanent pain, it can get worse, but never actually goes away for any period. It's just stuck the way it is it seems. This is all part of a group of symptoms I just posted about in the Urology forum here: http://www.doctorslounge.com/urology/fo ... hp?t=13934

It's really puzzling me. My doc is prescribing me Lexapro so I know he thinks I'm crazy. But, I just don't know what to look into. My plan is to rule out urological problems 100% if I can then move on to the muscles/nerves/skeleton type problems. Also, I have always wondered about a hernia in my groin. I've done all the cough tests, but I just wish I could get something more definitive.
 miclus - Tue Dec 26, 2006 12:01 am

Also, I'll add I don't think I had any calcium test. I had just your basic tests to test kidney function, urine tests and a urine culture and eps culture and some other tests for like lupus. Anyway, it's like I know what I want to do but it's harder than people think to get someone to listen. I feel like it's a Christmas present if the doc actually listens and orders tests. I don't know what it is, but I guess there's some insurance problem where they have to provide a reason to do tests. I just wish they could just order them and then we can figure something out hopefully. My urological plan, if it's safe to say it's not my kidneys, is to do these further tests.

1. Pelvic CT/MRI.
2. Cystoscopy.
3. Repeat EPS/Semen culture.
4. Transrectal Ultrasound.

My doc never fails to remind me that I'm not a doctor, and makes it seem like I'm self diagnosing, but these symptoms are crazy and my research for the past 20 months tells me that those tests are very useful, I don't care if they have to make up some problem to order them. I think if those are normal, I'll basically have to move on from urological stuff.

Do you agree with those tests or think there's any to add or remove?
 Dr. Chan Lowe - Tue Dec 26, 2006 2:15 pm

User avatar Suspecting that your pain may be coming from a urological source is reasonable. I would suggest a work up for kidney stones. Usually a stone can be seen on CT scan with contrast, but if they weren't looking specifically for kidney stones small stones can be overlooked. Also, it may be that the stone has passed and now is not being seen; however, with persistent pain this is less likely. The best way to assess calcium in the urine is via 24 hour urine collection.

I would suggest a thorough work up for urine calcium, renal stones, etc. before proceding to other CT scans, etc. The cystoscopy is unlikely to be helpful unless there is a specific finding that is being looked for.

Things such as prostatitis, epidymitis, testiculitis should present with pain on palpation of the respective structure. A self testicular exam that reveals pain is concerning for something along these lines.

Hope this helps.

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