[36M] With severe back pain and hematuria

Patient Description

A 36-year-old male presents with severe back pain, which he believes is related to his kidneys, and has been ongoing for the past three days. The pain is constant and does not change with different positions such as sitting, standing, or lying down. The patient has noticed blood in his urine and has only urinated once in the past three days despite drinking a lot of water. He reports experiencing fever, chills, and nausea but no vomiting. There is no history of recent trauma or injury to the back or abdomen, and no changes in diet or fluid intake. The patient has no history of kidney stones or urinary tract infections, although his mother had a kidney removed due to embedded kidney stones. The patient has not been evaluated for kidney stones or had any imaging studies done on his kidneys. He is not currently taking any medications and does not have any pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few serious conditions that could be causing your symptoms:

  1. Kidney Stones: Given your family history and the sudden onset of severe pain in the kidney area, kidney stones are a possibility. Kidney stones can cause severe pain, blood in the urine, and difficulty urinating. They can also lead to infections, which might explain your fever and chills.

  2. Urinary Tract Infection (UTI) or Kidney Infection (Pyelonephritis): Blood in the urine, fever, chills, and back pain can also be signs of a severe urinary tract infection or a kidney infection. These infections can become serious if not treated promptly.

  3. Bladder or Kidney Injury: Although you mentioned no recent trauma, internal injuries can sometimes occur without obvious external causes. Blood in the urine and severe pain could indicate an injury to the bladder or kidneys.

  4. Other Kidney Conditions: There are other kidney conditions, such as glomerulonephritis or interstitial nephritis, that can cause blood in the urine and pain.

What you can do

  1. Seek Immediate Medical Attention: Given the severity of your symptoms, it is crucial to seek medical attention immediately. You should go to the nearest emergency room or urgent care center. If you are unable to get there yourself, please call 911 or have someone drive you.

  2. Stay Hydrated: Continue to drink plenty of water, but avoid any beverages that can irritate the bladder, such as caffeine or alcohol.

  3. Monitor Symptoms: Keep track of any additional symptoms that may develop, such as increased pain, changes in urine color, or worsening fever and chills.

  4. Avoid Painkillers: Until you see a healthcare provider, avoid taking any painkillers, especially nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, as they can affect kidney function.

Remember, I am not a doctor, and it is essential to get a formal diagnosis and treatment from a healthcare professional. Your symptoms are serious and require prompt medical evaluation. Please seek care immediately.

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5 mo ago

People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the back or side, blood in the urine, nausea, vomiting, and frequent urination. The pain may come in waves and vary in intensity.


How can a urinary tract infection lead to kidney infection?

A urinary tract infection (UTI) can spread from the bladder to the kidneys if not treated promptly, leading to a kidney infection (pyelonephritis). Symptoms of a kidney infection include fever, chills, back or side pain, nausea, and blood in the urine.


What should I do if I notice blood in my urine?

If you notice blood in your urine, it is important to seek medical attention promptly. Blood in the urine can be a sign of a serious condition such as a kidney stone, infection, or injury, and requires evaluation by a healthcare professional.


Can severe back pain be related to kidney problems?

Yes, severe back pain can be related to kidney problems such as kidney stones, infections, or other kidney conditions. The kidneys are located in the back, and issues with them can cause pain in that area. It is important to seek medical evaluation to determine the cause.


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