Merck Manual

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Evaluation of Kidney and Urinary Tract Disorders


Paul H. Chung

, MD, Sidney Kimmel Medical College, Thomas Jefferson University

Reviewed/Revised May 2022 | Modified Sep 2022


A doctor obtains a medical history by interviewing a person. The interview includes questions about a person's symptoms, past medical history (what disorders the person has had), drugs (prescribed, over-the-counter, and recreational, including alcohol and tobacco), allergies, and disorders that run in the family. Typically, people with a possible disorder affecting the kidneys or urinary tract are asked about the following:

For example, because some foods and drugs may change the urine's color, doctors may ask about the person's diet. A person who is waking up often during the night to urinate may be asked about the amount, type, and timing of liquids drunk.

Physical Examination

Doctors then examine the person. (See Overview of the Urinary Tract Overview of the Urinary Tract Normally, a person has two kidneys. The rest of the urinary tract consists of the following: Two ureters (the tubes connecting each kidney to the bladder) The bladder (an expandable muscular... read more .) They may try to feel the kidneys. The kidneys usually cannot be felt in normal adults and children, except sometimes in very thin people. Kidneys can be felt in normal newborns. Doctors may strike the person's side or lower back (flank). Pain that occurs during this maneuver may suggest a problem with a kidney (such as swelling or infection). If a person has difficulty urinating and pressure in the lower abdomen, doctors may put a finger on the lower abdomen and tap on it. If the sound made by the tap is unusually dull, the bladder may be swollen (distended).

In men, doctors examine the genitals, including the testes, to ensure the testes are not swollen, tender, or abnormally placed. Doctors then do a rectal examination to determine whether the prostate gland is swollen. An enlarged prostate Benign Prostatic Hyperplasia (BPH) Benign prostatic hyperplasia (BPH) is a noncancerous (benign) enlargement of the prostate gland that can make urination difficult. The prostate gland enlarges as men age. Men may have difficulty... read more may inhibit the flow of urine.

In women, doctors may do a pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more to determine whether inflammation or irritation of the vaginal lining (vaginitis) or the genital organs are contributing to urinary tract symptoms.

Doctors may also examine the person's skin for changes related to kidney disease. They may listen to the heart and lungs with a stethoscope to detect unusual heart and lung sounds that may indicate a kidney disorder. If doctors suspect chronic kidney disease Chronic Kidney Disease Chronic kidney disease is a slowly progressive (months to years) decline in the kidneys’ ability to filter metabolic waste products from the blood. Major causes are diabetes and high blood pressure... read more , they check to ensure the person is not drowsy or confused.


Doctors sometimes need to do tests or procedures to diagnose a kidney or urinary tract disorder.

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