Category Archives: Urinary Tract Infection/Pyelonephritis

Hello, I had a CT scan 5 years ago before I had my gallbladder removed. I was told I have a ‘horse shoe’ shaped kidney, that they are fused together making it a ‘super kidney’. They told me I was born this way and I have lived my life not knowing. I haven’t had issues that I know of but is their any advice you can give me? Any knowledge about this as they just told me ‘drink lots of water’. I did have a UTI with low back pain one but antibiotics cleared it.

A horseshoe kidney is a congenital (you were born with it) abnormality which results in the bottom of each of your kidneys joined together and lying over your spinal column.  It is normally a totally asymptomatic condition.  The only problems … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Treatments, Urinary Tract Infection/Pyelonephritis

This is the result of a CT UROGRAM done in 10/2012. There are bilateral renal calculi. Specifically, there is an approximately 9 x 5 mm right upper pole calculus with focal prominent thinning overlying cortex consistent with sequelae of prior infection. There is an approximately 3 mm calculus centrally mid to upper pole left kidney. IMPRESSION: BILATERAL RENAL CALCULI, LARGER ON THE RIGHT WITH THINNING OVERLYING CORTEX CONSISTENT WITH SEQUELAE OF PRIOR INFECTION. NO RENAL MASS OR OBSTRUCTIVE UROPATHY. I’ve had shockwave done twice, once on the right in 2012 and once on the left last year. Recently I have been seeing my primary because of a UTI. I had an urinalysis done in office with the following results; Component Your Value Glucose neg mg/dL Bilirubin moderate Ketones trace mg/dL Spec Gravity 1.025 Blood large pH 5.5 Protein >=300 mg/dl mg/dL Urobilinogen 2.0 E. u> /dl EU/dL Nitrite positive Leuk. Esterase large Color red Pale yellow Appearance other, on period All of my pain is on the right side. I am nauseous, occasional vomiting, loss of appetite, and difficulty urinating. At times it is difficult to start a stream and at times only a drizzle comes out. The CT scan I had on 07/07/2017 did not show a stone on the right side. I have scarring in my right kidney due to a prior infection. So I am wondering is the stone that was originally there, able to hide behind the scarring and not be seen on CT? How does a 9 mm stone just disappear yet the 3mm one in the other kidney still be there? and if there is no stone, then why the crazy numbers on the urinalysis? Any thoughts would be helpful.

The problem that you present is a urological problem.  I am a nephrologist and have no expertise in the surgical management of kidney stone disease.  You need to consult with a urologist.  A urologist is a surgeon who deals with … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

I’m having some pain on each side of my hips ( back). If I do much activity during the day, at night it is so painful. Even when I cough, I can hardly stand it. Could this be a symptom of a kidney problem?

Pain is a very unusual symptom for kidney disease.  Pain can be present with kidney stones, infection or blockage of the kidneys, but this is very unusual.  I recommend that you see your physician and be examined.  It is much … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis

Hi doctor, I am 22 year old. I have an endstage renal disease secondary to vesicoureteric reflux disease with bilateral hydronephrosis with frequent urinary tract infection. I was on CIC and I was labeled as Hinman syndrome. I underwent bladder augmentation in June 2012 with ileocystoplasty and I was cleared for transplant by Urology. I started dialysis in December 2012, through the left AV fistula. I am having dialysis 3 times per week for 4 hours and I tolerate dialysis well. Currently, I am making minimal amount of urine only few drops on nondialysis and continues on bladder irrigation per urethra. No history of blood transfusion and no history of recent urinary tract infection. Regarding kidney transplantation, should the old kidney be removed first in a separate procedure? Or should it be removed and the new one be transplanted in the same procedure? and is it possible to stop doing CIC postoperatively? More details about the presenting complaint: I am a product of cesarean section as I was preterm with prolonged incubation for 2 weeks and neonatal ICU. At the age of 5 years, I was presented to Pediatric Urology Department with chronic urine retention and chronic constipation. Investigation at that time showed a creatinine of 60 and ultrasound showed severe bilateral hydronephrosis and VCUG showed vesicoureteric reflux. I was treated with a urethral catheter to evacuate the bladder, and I was labeled as Hinman syndrome Current medications: 1. Calcium carbonate 600 mg t.i.d. 2. Renagel 800 mg t.i.d. 3. Mapa (Acetaminophen) 325 g tablet Past medications of the same issue: SPS (Sodium Polystyrene Sulfonate) Suspension, Rocaltrol (Cacitirol), Nephro-vite (Multivitamine: Vit B Complex, Vit C and FA), Sodium CL, Zinnate (Cefuroxime), Aranse (Darbepoetin), FeroSul (Ferrous Sulfate) 65 mg elemental Iron, Amlor (Amlodipine). Klavox (Amoxicillin-Add to dictionary), Cipromax (Ciprofloxacin), Normoten (Atenolol), Add to dictionary (Calcitriol). Lab tests performed: 1. HLA Antibody identification: PRA I Screen – Luminex ID: Positive Class I PRA II Screen Luminex ID: Negative Class II Luminex Solid Phase Assay 2. CBC: Hematocrit: 0.356 L/L Hemoglobine: 116 g/L MCHC: 326 g/L MCV: 98.3 fL MPV: 10.4 fL Nucleated RBC Absolute Auto: 0.01 10`9/L Platelet: 220 10`9/L RBC: 3.62 10`12/L RDW: 14.3% WBC: 5.75 10`9/L 3. Chemistry: Urea: 12.0 mmol/L e-GFR: 6 mL/min/1.73`2 PO4: 2.30 mmol/L K: 5.4 mmol/L creatinine: 985 umol/L Cl: 94 mmol/L CO2: 33.0 mmol/L ALT: 7.4 U/L The

The decision to remove your old kidneys must be made by a urologist.  I am a nephrologist and do not perform surgery.  A urologist is a surgeon and has expertise in regards to urinary tract disease and bladder disease that … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

My Husband has CKD stage 4. Last May 2016, he had a UTI and was prescribed trimethoprim. After 4 days he was admitted to hospital with hyperkalemia (6.4) and an acute on chronic kidney injury. He is now on a diet to keep his potassium levels satisfactory. Today his local GP has diagnosed that he has a chest infection and has prescribed amoxicillin 500mg capsules for 7 days. Is this a suitable prescription for a patient with CKD stage 4. Would it be necessary or a worthwhile procedure to have a blood test taken when he has completed the 7-day course to identify if his potassium levels have been affected? What symptoms should one look out for or what tests should be done to check if he is diabetic.

Trimethoprim is known to cause high blood potassium because it interferes with the kidney elimination of potassium.  Penicillins such as amoxicillin do not usually cause potassium problems.  Your husband’s physician should be able to determine if he is a diabetic … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis

I am a female, age 58, no diabetes, or high blood pressure, recently tested GFR 48, down from GFR 68 twenty days ago. I have fluid retention and a lot of back pain with fever 100 – 102. No UTI (but suprapubic pain). Urinalysis: No protein, Leukocyte (70), hemoglobin small, all other normal. Doctors point at creatinine level (1.17) and believe due to dehydration and other symptoms not related to kidney. No referral to urologist, no diagnosis of kidney disease, no treatment offered for symptoms. Any recommendations to treat symptoms — now can’t work/function. Thanks. (p.s. I know need to push for more tests).

I am unable to make a specific diagnosis based on the information that you present.  I agree that you need further testing.  I suggest that you consult with your primary care physician for further testing or referral.  An ultrasound examination … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis

My 91 year old mother had 2 UTIs in January. She saw a urologist in late February. He referred her to a nephrologist who diagnosed her with stage 3 kidney disease in March. We have seen a rapid decline in her cognitive function since the first UTI (3 month time period). Is there a correlation between kidney disease and cognitive function? We keep asking about dementia and additional tests that should be run. We are told by the SN facility that there is nothing more they can do and they have no explanation for her sudden onset dementia.

Dementia is common in the elderly and may be worsened by infections of any kind, including urinary tract infections (UTI’s).  Early stage chronic kidney disease (CKD Stage 3) should not be a cause of dementia.  I can only suggest that … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis, Urological Issues

My father-in-law was diagnosed with benign prostatic hyperplasia, urolithiasis, chronic kidney disease secondary to obstructive uropathy. He has been experiencing recurrent UTI, and keep complaining of pain at hypogastric area. He became drug dependent to Tramadol that leads him to hallucination and delerium. His bladder cannot hold lots of urine due to bladder inflammation. We already did what the doctors says but still no improvement. The problem still the same and my father is still suffering from his condition. Please help us and give us recommendation.

The problem that you describe is a urological condition.  I am a nephrologist.  I have no expertise in diseases of the bladder and urinary tract.  I suggest that you discuss this with a urologist. For more information on Uti’s click here:

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

Hi Doctor, I’m a 27 year old, Korean, healthy, female. My blood pressure is always very low and I’ve maintained good health for the most part. For more than a year, I have experienced kidney pain and tenderness the night of and day after I drink alcohol. I’ve always thought it was nothing to worry about since I had ingested alcohol and thought this was my body’s normal reaction. There was a time when I didn’t have these symptoms, but it’s been a long time. Recently, I went to my PCP because my kidney pain lasted a few days after I had drank alcohol. My doctor did a UA and my results came back as follows: GLUCOSE, UA Negative mg/dL; KETONES, UA 80 (2+) mg/dL; SPECIFIC GRAVITY, UA 1.027; UA HGB 0.03 (1+) mg/dL; PH, UA 5.0; PROTEIN, UA 30 (1+) mg/dL; NITRITE, UA Negative; LEUKOCYTE ESTERASE, UA Positive; UROBILINOGEN, UA, QL Negative; BILIRUBIN, UA Negative…. WBC’S, UA/HPF 6-10 HPF; RBC, URINE HPF 4-10 HPF; MUCOUS, UR SED, QL, AUTOMATED COUNT Present HPF; HYALINE CASTS, URINE SEDIMENT, AUTOMATED COUNT, QUAL 5-10 LPF. In July, my GFR was 86 mL and my Vitamin D levels were 16ng/mL. I have not repeated a blood test since July. When I spoke with my doctor regarding my results, she stated she ruled out a UTI and a Kidney Infection. She referred me to a Urologist and Radiology for an ultrasound. I have had a kidney infection previously in 2012. I can’t get into my urologist until April, so naturally – I’m scared. Do these results lean toward a kidney stone being present? Could it have been present for over a year and only agitate when I drink alcohol? Or do these seem to point toward diseased kidneys? I’ve lost about 12 pounds in the last couple months (108lbs, 5’3″) and have (in the last week) a decreased appetite. In the last four days, I have been experiencing a low grade fever and chronic, dull pain/heaviness in my kidneys. Since I have experienced a kidney infection before, I am reluctant to go to the ER to see a specialist sooner. Are these symptoms something I need to address sooner than April?

I am unable to provide a specific diagnosis based on the information that you provide.  I am a nephrologist and I cannot make a diagnosis of kidney disease based on the information that you describe.  I agree that you should … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

What does mildly lobulated left renal parenchyma with slightly heterogeneous echotexture mean? I am 44 yrs old with recurrent UTIs, sharp back pain on occasion, eye swelling & leg swelling.

I am unable to interpret a scan without seeing the scan myself.  I suggest that you discuss this result with the physician who ordered the scan.  I am not able to make a specific diagnosis based on the information that … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Treatments, Urinary Tract Infection/Pyelonephritis