How to check for painful pressure and percussion in the kidney area

Pressure and percussion pain in the renal area is one of the clinical manifestations of renal vein thrombosis. It is caused by various diseases in the kidney area, and pressure and percussion on the kidney area by hand will produce pain. The following is the introduction of how to check the pressure pain and percussion pain in the kidney area. 1.General examination Urine routine: it includes pH, relative density (specific gravity), red blood cells, pus cells, protein, sugar, crystals, etc. Hematuria, crystaluria and pus cells can be found in the urine of patients with urinary stones. Urine pH is often indicative of a certain type of stone: patients with calcium phosphate and carbonate apatite stones often have a urine pH higher than 7.0; while patients with uric acid, cystine and calcium oxalate stones often have a urine pH less than 5.5. Microscopic hematuria or carnal hematuria can be seen. However, hematuria is absent in 15% of patients. In non-infected stones, there may be mild pusuria. 2.Special examination Urine crystallization examination: fresh urine should be retained. If phenyl-like cystine crystals are seen suggesting possible cystine stones; if uric acid crystals are found in urine, it often suggests possible uric acid stones; if envelope-like crystals are found they may be calcium oxalate dihydrate stones; coffin lid-like crystals are magnesium ammonium phosphate crystals; sulfonamide crystals will be found in the urine of patients suspected of having sulfonamide stones. Urine bacterial culture: colonies >105/ml are considered positive. Drug sensitivity testing then provides information on the most effective antibiotic. A urine culture with urea-producing bacteria is likely to indicate the presence of infected stones. 24h urine test: 24h urine must be collected correctly and the urine measurement should be accurate. The content of the test includes: 24h urine calcium, phosphorus, magnesium, citrate, uric acid, oxalic acid, cystine, etc. 3. Blood biochemical examination Normal adult serum calcium is 2.13-2.6mmol/L (8.5-10.4mg/dl) and inorganic phosphorus is 0.87-1.45mmol/L (2.7-4.5mg/dl). In patients with primary hyperparathyroidism, serum calcium is higher than normal, often above 2.75 mmol/L (11 mg/dl), and is accompanied by a decrease in serum inorganic phosphorus. In normal adult men, serum uric acid does not exceed z416.36mmol/L (7mg/dl) and in women, it does not exceed 386.62mmoL/L (6.5mg/dl). When this value is exceeded, hyperuricemia is considered. In patients with gout, blood uric acid is increased. Kidney stones with renal dysfunction often have acidosis, when serum electrolytes are altered, serum sodium and carbon dioxide binding carbon binding is reduced, and blood potassium is elevated to varying degrees. Hypokalemia and hyperchloremic acidosis may occur in renal tubular acidosis. Measurement of urea nitrogen and creatinine can give an idea of the patient’s renal function. Urea nitrogen and creatinine in blood can be increased to varying degrees when renal function is impaired. In conclusion, blood and urine tests in patients with urinary stones can help to understand the renal function, the presence of complications of infection, the possible types of stones and the causes of stones, and can be useful in guiding the treatment and prevention of stones.