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How to palpate kidney?

Lower Pole of right kidney is normally palpable.
Left kidney is usually not palpable unless either low in position or enlarged
Use bimanual technique to palpate the kidneys.
Method of palpation of kidney
  • The patient lies flat on his back.
  • The examiner's left hand slides underneath the back to rest with the palm of the hand under the right loin.
  • The fingers remain free to flex at the metacarpophalangeal joints in the area of renal angle.
  • The examiners right hand is placed over the right upper quadrant.
  • Flexing the fingers of the Left hand can push the contents of the abdomen anteriorly.
  • Firm pressure is exerted by both hands at the height of inspiration to trap the palpable kidney between the two hands, otherwise it will prevent the descend of kidney by the diaphragm.
  • Assess the size, surface and consistency of the palpable kidney.
  • It is more often possible to feel a kidney by balloting.
  • In this case the renal angle is pressed sharply by the flexing fingers of the posterior hand.
  • The kidney can be felt to float upwards and strike the anterior hand. Left kidney is also palpated in the same manner.
  • Palpate the renal angle for tenderness.
  • Though kidney is retroperitoneal, it moves with respiration since it is related to the crus of the diaphragm posteriorly, the movement of the diaphragm is reflected to kidney producing restricted movement during respiration.

Causes of palpable kidney 
Unilateral palpable kidney
  • Normal Right kidney
  • Hypernephroma
  • Hydronephrosis/pyonephrosis
Bilateral palpable kidney
  • Polycystic kidneys
  • B/L hydronephrosis/pyonephrosis