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Forum Name: Miscellaneous Nephrology Topics

Question: Lower back/flank pain on right side, occult blood in urine


 caoimhin - Thu Nov 13, 2008 2:21 pm

Within the past few days, I've developed a dull pain in my lower right back side. I was in the emergency room several days ago for abdominal pain, and all blood tests (CBC, LFT, amalyse, lipase) came back normal, but they found occult blood in my urine.

For months, my urine has looked concentrated--and often doesn't mix uniformly with the water in the toilet. The color is normal, and becomes clearer when I drink more liquids, but the urine seems to be heavier than the water, and sometimes sinks to the bottom of the bowl.

I had a CT scan today without contrast. It found no kidney stones. Any other ideas about what could cause these symptoms?
 Dr. Safaa Mahmoud - Thu Nov 13, 2008 6:07 pm

User avatar Hello,
It would be helpful if you can inform us about the exact results of the tests done, CBC, KFT (urea, creatinine), uric acid, and your serum protein and the lipid profile.

For the urine analysis, it is very important to know the PH, specific gravity, the amount of proteins, blood, and any other solutes in the urine tested. If the urine anylsyis showed pus in urine or any bacteria and its count would be very informative.

If you have symptoms like loin pain and fever, UTI should be excluded.
If you have dysuria, frequency and or urgency, this indicated urinary tract infection.
Blood in the urine and pain is seen in cases of infection in the kidney (pyelonephritis), and bladder (cystitis) or a moving stone in the ureters or the urethra. The presence of a blood clot can give clinical picture similar to that produced by stones. CBC and blood smear may suggest the presence of blood hemolysis and anemia.

Concentrated urine is seen in dehydrated persons, kidney or endocrine diseases. Evaluation of urine specific gravity and the complete urine analysis provide an idea about possible causes.

I assume that your doctor wanted to first exclude stones since it is a common cause of pain and hematuria, then he will go for further investigations based on your medical history and the results of your clinical examination and lab tests.

I would advise you to follow up with your doctor and to complete your investigations.
Please keep us updated.
Best regards.
 caoimhin - Thu Nov 13, 2008 8:31 pm

Thank you very much for your reply.

Unfortunately, I don't have any information about the numbers. They only told me that the results were "negative" and normal. I was told my urine was clean except for the occult blood.

I am a 23 year old male with no history of kidney stones, or kidney issues in the family.

I am certainly going to follow up with my doctor. I am terrified of what could be causing this pain.
 johnboy - Wed Jan 28, 2009 4:34 am

i have been in hospital with pyelonephritis i have been home for just over a week and finished all tablets given. i still have back ache should i still have this and if so how long should it last.

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