From the Guidelines
The right kidney is typically palpable, not the left kidney. In a normal physical examination, only the right kidney can usually be felt (palpated) in some patients, particularly those who are thin or have a low body mass index. The right kidney sits slightly lower in the abdomen than the left kidney due to the presence of the liver above it, making it more accessible to palpation 1.
To palpate the right kidney:
- Have the patient lie on their back
- Place one hand behind the patient's back just below the ribcage
- Place the other hand on the front of the abdomen just below the ribcage
- Ask the patient to take a deep breath
- As they exhale, gently press your hands together to feel for the kidney
The left kidney is generally not palpable in normal individuals because it sits higher in the abdomen, protected by the ribcage and overlying organs. If the left kidney is felt during examination, it may indicate an enlarged or displaced kidney, which could warrant further investigation 1. Understanding kidney palpation is important for physical assessment and can help detect potential abnormalities in kidney size, position, or texture. The use of ultrasound imaging can also facilitate the visualization of the kidneys, particularly in emergency situations 1.
From the Research
Kidney Palpability
- The right kidney is more likely to be palpable due to its anatomical position, as seen in a study where the anterior position of the lower pole of the right kidney was found to be a potential cause of confusion with a right upper quadrant mass 2.
- In a case study, the right kidney was found to be palpable due to its abnormal position and rotation, which may be a result of renal ectopia 3.
- However, the left kidney is generally larger than the right kidney, which may affect its palpability, as found in a study on ultrasonographic renal size in individuals without known renal disease 4.
Anatomical Variations
- The position and size of the kidneys can vary between individuals, with some studies finding that the right kidney is higher than the left kidney in a small percentage of cases 5.
- Congenital anomalies, such as horseshoe kidney, can also affect the position and structure of the kidneys, as seen in a case report where the kidney was placed at a lower level than normal 6.
- These anatomical variations can affect the palpability of the kidneys and should be considered in medical evaluations.