Kidney Pain

The term ‘Kidney Pain’ or ‘Renal pain’ is used randomly whenever a flank pain is felt. This necessarily need not be a pain from the kidney. A variety of causes can always be confused with kidney pain.

Consequently, to differentiate the cause of the pain, it is pertinent to understand where kidney exactly is placed in the body.

kidney pain in flanks

Image1 & 2: Kidney pain is felt in the flanks. [3, 4]

Kidney Location (Anatomy)

The kidneys are located in the abdomen (below the diaphragm), nearer to the back side. They are bean shaped organs. Most of it is protected by the back end of the ribs. The right kidney is pushed down slightly by the right lobe of liver. To know about the liver position in the body, kindly refer to ‘Liver Location’.

Surrounding the kidneys there is a layer of fat which further helps in protecting it from blunt injuries.

kidney location image

kidney anatomy location surface anatomy picture image


surface anatomy of kidney

Image 3 (a,b,c) : The kidneys when seen from behind (back)(surface anatomy) . It can also be noted that its position is corresponding to T12 (Thoracic) vertebra to L3 (Lumbar) vertebra. [5]

kidney urinary system ureters anatomy location

Image 4 & 5: From the above image, it is clearly visible that kidneys are placed more towards the back of the body in both male and female. The tubes which connect the Kidneys to the bladder are called as ‘Ureters’ and that which passes the urine from the bladder to the outside is called a ‘Urethra’. [6]

four quadrants kidney location

Kidney location in relation to four quadrants of abdomen

Functions of the Kidneys

  • Helps in regulating the fluid volume inside the body.
  • Helps in regulating the acid base balance inside the body.
  • Removes the toxins, drugs and waste products from the blood.
  • Helps in regulating the electrolyte balance in the body.
  • Produces hormones and neuro-transmitters.[13]

Kidney Pain Location

Where is Kidney Pain felt?

kidney pain location areas picture images

Image 6: The colored areas in the image are the region in which renal pain/ kidney pain/ flank pain occurs. [7]

referred pain in kidney areas backReferred pain pattern in kidney pain and its areas in yellow color

What does kidney pain feel like?

Generally the pain from kidneys is felt as dull aching pain[2]. Occasionally when there is a sudden obstruction of the ureters due to a stone, the ureters try to push it downward by its own movement. This may cause a sharp pain (renal colic) [1].

What causes Kidney pain/ flank pain?

The pain which is referred to as kidney pain may sometimes not be from kidneys at all.

What are the possible conditions causing similar pain? Differential diagnosis

Condition Site of Pain Clinical findings
Appendicitis Near to the umbilicus and radiates to the right lower quadrant of the abdomen.
  • Pain
  • Nausea
  • Vomiting
  • Anorexia
  • Tenderness at Right lower quadrant.
Acute urinary retention Lower abdomen
  • Lower abdomen pain
  • Inability to urinate
  • Swelling/enlarged and full bladder can be seen and felt on the lower abdomen.
Cystitis Lower abdomen
  •  Lower abdomen/ Suprapubic pain
  • Painful urination (Dysuria)
  • Increased frequency of passing urine (Frequency)
  • Compelling urge to urinate (Urgency)
  • Blood in urine (Haematuria)
Diverticulitis Left or Right lower quadrant of the abdomen
  • Constant pain in the left or right quadrant of the abdomen.
  • Nausea
  • Vomiting
Endometriosis Left or right lower quadrant of the abdomen
  • Painful periods (Dysmenorrhoea)
  • Pain with intercourse
  • Pain while passing urine or bowel movements
  • Heavy periods (menorrhagia) or bleeding in between periods
  • Infertility
  • Nausea, vomiting, diarrhoea, constipation
Infectious colitis Right or left lower quadrant of the abdomen. But may present as whole abdomen pain.
  • Pain abdomen
  • Diarrhoea
  • Fever
  • Chills
Lower back pain Pain in the lower back
  • Pain associated with position, positional change and exercise.
Nephrolithiasis Pain maybe in the flanks, lower abdomen or back
  • Pain maybe dull aching or sharp
  • Pain maybe continuous or intermittent
  • Nausea, vomiting
Pyelonephritis Flanks, lower abdomen or back
  • Dysuria
  • Frequency
  • Urgency
  • Haematuria
  • Tenderness just over the kidney area. (Costo-vertebral angle)

Table: Differential diagnosis for flank pain. The above given are conditions that may resemble kidney pain. [8, 9, 10, 11, 12]

So What Causes Pain in Your Kidneys?

Pain in the kidneys can be due to any obstruction in the urinary tract (Kidneys, ureters, Bladder, urethra), disease of the urinary tract, congenital abnormalities or malignancies. [2, 14, 15, 16]

Condition Site of pain Clinical findings
Polycystic Kidney disease- Multiple cysts in the kidneys [17] Back pain or abdominal pain
  • Palpable lump on both sides in the upper abdomen.
  • Hematuria
  • Frequent urinary tract infections
Hydronephrosis- Swelling of the kidney Upper back or flanks
  • Pain due to the obstruction in the urinary tract that has led to the swelling. [18]
Pyelonephritis- Infection of the kidney [20] Flanks (Left, right or both)
  • Dull, aching pain
  • Nausea
  • Vomiting
  • Fever, Chills
  • Anorexia
Rupture of cyst in kidney [19] Flanks
  • Pain in the flanks
  • Haematuria
  • Fever
Kidney tumours [19] Flanks and Upper back
  • Pain in the flanks
  • Haematuria
  • Fever
Stones in kidney, ureter or bladder [21, 22] Upper back, flanks, lower abdomen
  • Dull aching to severe sharp stabbing pain radiating to the flanks, groin and inner thighs.
  • Nausea, Vomiting
  • Haematuria
Urinary tract infection Lower abdomen
  • Dysuria
  • Haematuria
  • Frequency
  • Urgency
  • Fever with chills
Glomerulonephritis [23] Flanks and Upper back
  • Generalized and pedal oedema
  • Haematuria
  • High blood pressure
Renal vein thrombosis [24, 25] Lower back and sides of abdomen
  • Abdomen pain
  • Fever
  • Haematuria
  • Decreased urine output

Symptoms & Signs of Kidney disease

The symptoms and signs mentioned below are usually found with kidney or urinary tract diseases. It is important to get a medical attention to diagnose the exact cause for appropriate management of the condition[2].

  • Fever
  • Pain
  • Dysuria- Painful urination.
  • Haematuria- blood in the urine
  • Frequency- Increased frequency of passing urine
  • Urgency- Compelling urge to urinate
  • Nausea
  • Vomiting
  • Anorexia
  • Chills
  • Edema – Swelling in the ankles. Sometimes there can be generalized oedema which occurs throughout the body.

How is Kidney Pain diagnosed?

Diagnosis over kidney pain involves a proper history evaluation and examination by the doctor. In most conditions, the doctor will have an initial suspicion regarding the cause of the pain. This will further be confirmed or excluded by appropriate investigations which will be advised. The usual investigations involved in diagnosis of kidney pain include the following. [2]

  • Complete blood count
  • Urine routine examination
  • Urine culture and blood culture
  • Kidney function tests- Blood urea, serum creatinine, blood urea and nitrogen
  • Pregnancy test
  • Ultrasonography of the abdomen and KUB region
  • Abdomen- CT/ MRI


The treatment of kidney pain depends on the cause of the pain itself. If it is a stone, the stone has to be removed. If it is an infection, then antibiotics needs to be given. Symptomatic treatments are also provided such as pain killers and antipyretics. Certain conditions like malignancy would require extensive surgeries to be done. [2]

General measures

  • In kidney stones, avoid chickpeas, cauliflower, carrots, turnips and increase intake of watermelons, grapes, Cranberry juice, grapefruits etc[26].
  • Avoid alcohol which can aggravate the pain.
  • Drink more water daily.
  • Plenty of rest.


  1. Dave, C., MD. “Nephrolithiasis.” Medscape. Updated: Aug 07, 2016.
  3. Image 1:
  4. Image 2:
  5. Image 3:
  6. Image 4 & 5:
  7. Image 6:
  15. Accessed Jan. 14, 2017.
  17. Diagnosis and management of chronic kidney disease; Scottish Intercollegiate Guidelines Network – SIGN (June 2008)

Published on November 25th, 2017 by under Pain Management.
Article was last reviewed on January 12th, 2022.

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