Symptoms:

Acute or emergency symptoms:

• Blood in the urine
• Flank pain, severe
• Abdominal pain
• Back pain
• Nausea, vomiting
• Abdominal swelling
• Fever (sometimes)
• Decreased alertness
  • Drowsiness, lethargy
  • Coma
• Increased heart rate
• Pale skin
• Sweating
• Skin cool to touch
• Decreased urine output
• Inability to urinate

Chronic symptoms:

• Irritability
• Weight loss
• Constipation (with toxic injury, lead poisoning)

Signs and tests:

A history of physical injury, exposure to potentially toxic substances, or recent infections or illness may show the source of injury to the kidney. If there is loss of blood, examination by touch (palpation) may reveal extreme tenderness over the kidney.

There may be signs of hemorrhage and shock, including rapid heart rate and falling blood pressure. Toxic injury or injury from inflammation may cause acute or chronic renal failure.

• Urinalysis may show blood. It may show sediment or crystals that show inflammation or toxic accumulations of uric acid or other substances. Part of the urinalysis is an RBC urine test. This may show increased red blood cells due to renal tumors, trauma, stones, or necrosis.
• CBC may show bleeding, infection, or inflammation. Other blood tests may reveal toxic levels of suspected substances.
• Electrolyte analysis of the blood may demonstrate increased potassium, urea, or creatinine.
• Kidney x-ray, abdominal CT scan, or abdominal MRI scan may show damage to the kidney.
• Renal scan may show problems with kidney blood flow.
• Angiography of the artery or vein may show occlusion of blood flow to or from the kidney.
• IVP (intravenous pyelogram) shows the functioning of the kidney. The IVP may be repeated after treatment of kidney injury to assess functioning of the traumatically injured kidney.