Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek urgent or emergency care for:
Fever or chills with back, side, or abdominal pain
Inability to urinate
Very little urine, especially with swelling, weakness, or shortness of breath
Severe or rapidly worsening pain
Repeated vomiting or inability to keep fluids down
Confusion, fainting, or severe weakness
A nephrostomy tube that stops draining, falls out, or is associated with fever or worsening pain
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact the treating clinician promptly for new urinary difficulty, increasing pain, visible blood in the urine, leaking around a drainage tube, or a clear change in urine output.
3
Does any of this apply?
Book an appointment
Follow-up is used to confirm that urine is draining, kidney function is stable or improving, and the underlying cause has been addressed.
The plan may include repeat blood tests, urine testing, bladder-emptying measurements, or follow-up imaging.
People with a catheter, stent, or nephrostomy tube need instructions for care and a clear plan for removal or replacement.
Routine follow-up is important even when pain improves.
Loss of pain does not always mean that an obstruction has fully resolved.
Keep scheduled appointments and ask when kidney tests or imaging should be repeated.
Every sign above is quoted from the sofidex article on Bilateral hydronephrosis. If you are not sure, err upward — it is always reasonable to be checked.