Injury - kidney and ureter

Definition

Injury to the kidney and ureter is damage to the organs of the upper urinary tract.

Alternative Names

Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury; Pre-renal failure - injury; Post-renal failure - injury; Kidney obstruction - injury

Causes

The kidneys are located in the flank at either side of the spine. The flank is the back of the upper abdomen. They 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 also surrounded by a layer of fat. The fat helps to cushion them.

The kidneys have a large blood supply. Any injury to them, can lead to severe bleeding. The many layers of padding help prevent kidney injury.

Kidneys may be injured by damage to the blood vessels that supply or drain them, including:

Kidney injuries may also be caused by:

The ureters are the tubes that carry urine from the kidneys to the bladder. Ureteral injuries may be caused by:

Symptoms

Emergency symptoms may include:

Long-term (chronic) symptoms may include:

If only one kidney is affected and the other kidney is healthy, you may not have any symptoms.

Exams and Tests

The health care provider will examine you. Let them know about any recent illness or if you have come into contact with toxic substances.

The exam may show:

Tests that may be done include:

Treatment

The goals are to treat emergency symptoms and prevent or treat complications. You may need to stay in a hospital.

Treatments for a kidney injury may include:

Sometimes, surgery is needed. This may include:

Outlook (Prognosis)

How well you do depends on the cause and severity of the injury.

Sometimes, the kidney starts working properly again. Sometimes, kidney failure occurs.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have symptoms of an injury to the kidney or ureter. Contact the provider if you have a history of:

Go to the emergency room or call 911 or the local emergency number if you have decreased urine output after a kidney injury. This may be a symptom of kidney failure.

Prevention

You can help prevent injury to the kidneys and ureter by taking these steps:

References

Brandes SB, Eswara JR. Upper urinary tract trauma. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 90.

Breyer BN, Cohen AJ. Retroperitoneal injuries: kidney and ureter. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1197-1203.

Okusa MD, Portilla D. Pathophysiology of acute kidney injury. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 28.



Review Date: 7/4/2022
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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