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I am a 26 year old female who has suffered from back pain in the kidney area for around a year. I have taken a lot of combination painkillers (ibuprofen, paracetamol and codeine - alternating with the paracetamol and ibuprofen but always with codeine) for over two years old patientand have been drinking alcohol quite heavily most nights until recently.

A liver test and urine test have shown no dysfunction of kidneys or liver, however the pain is persistent and I have a ultrasound scan booked for next week. I would like to know if an ultrasound scan will successfully diagnose analgesic nephropathy or nephrotic syndrome, or should I request more tests?

Is there a chance I could have kidney damage even without blood / protein in the urine?
Thanks for your time.

Category: Nephrologist

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Category: Pediatric Nephrologist
 21 Doctors Online

Thank you for your query at
Your pain may not be related to the kidneys. Contrary to the common belief, kidney problem doesn't manifest as pain in the lower back. Even if it causes , it's one of the rarest manifestations.
Most of the times a stone or done thing to do with kidneys discovered accidentally when ultrasound is done for abdominal pain . You don't need to worry .
We can wait for the CT reports to be available and then take a decision. Ct is better than ultrasound to search for nephrotic syndrome or analgesic nephropathy. Ultrasound can also give an idea, however CT is preferred.
And if the kidney is damaged it will show in the ultrasound. If your urea and creatinine are fine, then again there is nothing to worry about.
Feel free to discuss further,

Patient replied :

Hello, Thanks for your answer, it's much appreciated! I would just also like to know whether the blood and urine tests I had would have confirmed no problems with creatinine and urea, as you mention? I was under the impression it was just blood and protein that the doctor was trying to detect.. or are those just jargon words for the same thing? Also, is nephrotic syndrome / analgesic nephropathy likely to go away with discontinuation of the medicines? Once again thanks :) Regards, Kate.

As you mentioned all the urine and blood tests are supposed to be normal, we can presume that most of the functions are normal . However structural change in the kidney can be assessed only with ultrasound scan or ct scan. You are at risk of kidney problem as you have been taking lot of pain killers but it won't manifest suddenly or so soon. You try to avoid now itself as any subtle change won't be seen at this stage. Nephrotic syndrome or analgesic nephropathy won't reverse as soon as you stop the culprit as it would be like removing the knife after stabbing. The stab injury will lead to complications and it won't get reversed if you take out the knife from the wound.
Hope this was helpful,

Dr. Sree Bhushan Raju
Category: Pediatric Nephrologist
FISN : Fellowship of Indian Society of Nephrology(ISN), 2012
FIACM : Fellowship of Indian Association of Clinical Medicin(IACM), 2012
FICP: Indian College of Physicians Association of Physicians of India, 2012
Fellowship: DM, DNB, All India Institute of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, Nizam's Institute of Medical Sciences, 1998
Medical School: MBBS, Gandhi Medical College, 1994
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