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Kidney pain
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Kidney pain

I have had pain on my right side sharp pain for over seven years now. Finally a doctor got a CT-Scan done, a doctor a year ago told me it was my appendix so I went to the emergency but it was a false alarm. They found out I had multiple fibroids. I have to go see a urologist because I was told I had sponge kidneys. Lately the pain has gotten worst. I have pain in my kidneys, then minutes later I have a sharp stabing pain in both side of my stomach, then I start getting a fever and I have pain in the middle of my back, seems like something is stuck or something. I'm concerned that my fibroids might be doing damage to my kidneys as well, this is why I'm also going to see a gynecologist. These appointments will take a few months. Can fibroids cause more damage to my kidneys? I have two large one's about 5cm each and other smaller ones. I just want the pain to go away. They did not see stones in the ultrasound, not sure if I have any, the urologist will let me know  when I see him in about a month. Until then I'm in pain daily. If the pain really gets unbearable I will go to the emergency. I've had this pain for so long that I have learned to deal with it. I'm not sure if the pain is coming from my kidneys, my fibriods or both....

Thank you
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242604_tn?1328124825
Hi There,

I am not sure whether 5 cm fibroids are big enough to affect your kidneys. you should ask the urologist if your pain is related to having sponge kidneys. I have pasted a good summary below. if your kidneys are chronically infected, you will have pain
best wishes
Background: Medullary sponge kidney (MSK) is likely the result of an abnormality in renal development as evidenced by the occasional presence of embryonal tissue in the affected papillae. Medullary sponge kidney is characterized by ectasia and cystic formation in the medullary collecting duct. This characterization contrasts with autosomal recessive polycystic kidney disease and with autosomal dominant polycystic kidney disease, in which cysts predominantly develop along the cortical collecting tubule or the entire nephron, respectively. Medullary cysts give the kidney the gross anatomic appearance of a sponge. In the absence of hematuria, renal calculi, or infection, the disease is an asymptomatic nonprogressive condition.


Pathophysiology: The kidney is the primary organ affected. Ectasia and cystic malformation are present along the intrapyramidal or intrapapillary portion of the medullary collecting duct. Cysts may be heterogeneous in size within one kidney and between the 2 kidneys, ranging in size from 1-3 mm. Cysts may communicate and often contain spherical concretions composed of apatite.

Although the cause of medullary sponge kidney is unknown, family occurrence suggests a genetic component. Pathological studies suggest that medullary sponge kidney is due to an obstruction of the fetal-collecting duct or to a structural defect caused by hypercalciuria. The presence of embryonal remnant tissue in some cases links the condition to a congenital developmental defect in this nephron segment.

Medullary sponge kidney may be part of other syndromes and conditions such as Beckwith-Wiedemann syndrome (BWS), hemihypertrophy, Caroli disease, Ehlers-Danlos syndrome, Marfan syndrome, and pyloric stenosis. Medullary sponge kidney may occur in up to 12.5% of cases of BWS, if congenital hemihypertrophy is part of the clinical picture.


Frequency:


In the US: Prevalence is 1 case per 5,000-20,000 population. Medullary sponge kidney may be detected in 0.5-1% of asymptomatic individuals who undergo renal imaging studies for assorted clinical indications.
Internationally: Evidence indicates that worldwide incidence of medullary sponge kidney is similar to that in the United States.
Mortality/Morbidity: Morbidity or mortality is not directly related to medullary sponge kidney. In the absence of hematuria, urinary tract infection, or renal calculi, medullary sponge kidney is usually a nonprogressive asymptomatic condition.

Under normal conditions, patients may have a mild urinary-concentrating defect or low-grade proteinuria.
Patients are at higher risk of developing calcium oxalate/apatite or struvite renal calculi. Factors that may contribute to the susceptibility to recurrent calcium urolithiasis include: (1) urine stasis; (2) incomplete renal tubular acidosis (RTA) with a mild defect in urinary acidification and increased urine pH levels; (3) hypocitric aciduria; and (4) hypercalciuria. Patients are usually aged 20-50 years at presentation, although the condition may occur in children younger than 5 years. Up to 20% of adults with kidney stones may have medullary sponge kidney; the corresponding figure in children is unknown. Among patients with kidney stones, hypercalciuria may occur in 40-50%, and recurrent gross hematuria may occur in 10-20%.
Although no evidence indicates that risk of urinary tract infections (UTIs) is higher in patients with medullary sponge kidney, up to 5% of males and 35% of females have a UTI. These patients do not have an increased frequency of concomitant structural anomalies (eg, vesicoureteral reflux) to account for the occurrence of UTI.
Race: No epidemiologic data indicate that incidence varies among racial or ethnic subgroups.

Sex: No evidence indicates that the frequency differs between the sexes. Fewer than 5% of cases are familial, and a clear genetic basis for medullary sponge kidney has not been established. The only genetic pattern observed in select pedigrees is an autosomal dominant type of transmission. Medullary sponge kidney appears to be somewhat more severe in women; the incidence of renal calculi and UTIs in women is higher than in men.

Age: Symptoms occur primarily in adults aged 20-50 years; however, infants as young as 2 years and adolescents have shown clinical symptoms.




  CLINICAL  Section 3 of 10      
Author Information Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Bibliography



History:

Patients are usually asymptomatic.
Patients may develop microhematuria or signs and symptoms of gross hematuria, renal stone development, or UTI.
Physical:

Although physical examination findings are usually normal, as many as 25% of patients have hemihypertrophy, and 10% of patients with hemihypertrophy may have medullary sponge kidney, although no explanation for this association exists. Children with medullary sponge kidney and hemihypertrophy may have an incomplete form of Beckwith-Wiedemann syndrome (BWS). Moreover, because of the high risk of malignancies in patients with BWS, these patients should be screened periodically for malignancies, including abdominal tumors.
Urinalysis findings may show hematuria, low-grade proteinuria, and mild acidification and concentrating defects.
Causes: The cause of medullary sponge kidney is unknown.

No cases link medullary sponge kidney to a drug or environmental exposure.
Cases occasionally occur in a familial pattern consistent with autosomal dominant transmission.
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