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Renal colic
Other Resources UpToDate PubMed

Renal colic

Contributors: Abhijeet Waghray MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Renal colic is the acute onset of severe abdominal / flank pain due to kidney stones. Pain typically radiates from the flanks to the groin and intensifies over the first 30-60 minutes. Eliciting a history of prior nephrolithiasis, a family history of kidney stones, or patients at risk of nephrolithiasis (eg, gastric bypass surgery, short bowel syndrome) should raise suspicion for a diagnosis of kidney stones. Some medications are associated with the development of kidney stones.

Renal colic is a common presenting symptom for nephrolithiasis. Risk factors for kidney stone formation include a prior stone formation (approximately 50% recurring within 5 years without preventive measures), family history, gastrointestinal surgeries, and systemic disease (eg, diabetes mellitus type 2, hypertension). Nephrolithiasis can occur at any age with a peak incidence between 20-49 years.

Nephrolithiasis is also associated with systemic diseases such as hyperparathyroidism, metabolic syndrome, nephrocalcinosis, gastrointestinal disease associated with impaired intestinal absorption, and sarcoidosis. Other risk factors for nephrolithiasis include insulin resistance, obesity, gout, and low fluid intake.


N23 – Unspecified renal colic

7093002 – Renal colic

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Pyelonephritis
  • Loin pain-hematuria syndrome
  • Renal cell carcinoma
  • Ectopic pregnancy
  • Ovarian torsion or rupture
  • Renal arteriovenous malformation
  • Acute cholecystitis
  • Acute mesenteric ischemia
  • Dysmenorrhea

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:03/06/2018
Last Updated:08/31/2023
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Renal colic
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