Category Archives: Urinary Tract Infection/Pyelonephritis

Hi there. I got some test results in today and the note said to come here. GFR MDRD Af Amer 99 See Note See Note. GFR is estimated using Creatinine, age, gender and race. Patient’s values should be interpreted as a trend. Below 90 ml/min/1.73m2, the patient may have renal disease.

The result mentioned is that your estimated glomerular filtration rate (eGFR) is 99 milliliters per minute per 1.73 meters squared if you are African American and 81 milliliters per minute per 1.73 meters squared if you are non-African American. In … Continue reading

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

I have just posted my question yesterday and you told me that all the sympstoms I stated seems to be not related with CKD as CKD Stage 3 usually doesn’t have any symptoms yet. He has undergone kidney biopsy last December and we are told by the doctors that he has CKD Stage 3 and only 48% of his kidneys is working. As you have said that it may imply other severe kidney diseases, why is it that the biopsy detected that he has CKD? Thank you.

The kidney biopsy is the definitive way to diagnose chronic kidney disease (CKD) and tells you what disease process is causing the kidney damage.  The Stage of CKD is determined by measurement of a glomerular filtration rate (eGFR) and performance … Continue reading

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

I have just recovered (I think ) from my 4th Kidney infection . I do not know why I keep getting these. My doctor mentioned that he was going to flush and clean out my bladder but during the follow up he never mentioned it. He said that I had bladder cancer however I read three bladder cancer tests that I took. One was negative but 2 were positive so he said I do not have bladder cancer. My CT exam noted that there is a 3 mm calculus in the right distal ureter just proximal to the ureterovesical junction (5:85). There is a punctate non obstructing right lower pole renal calculus. There is no hydronephrosis. However, I have not passed the stone as far as I can tell. And my doctors office during one visit he said I had two small stones one in each kidney but then the follow up he said he just couldn’t see anything. Could I pass a stone and not realize it? Should I get a second opinion regarding the cancer diagnosis and the reason why I keep getting kidney infections? My urologist has told me at one appointment that I do not empty my bladder. Is there a way to do this or do I need a procedure? Thank you I really appreciate your help this is an excellent resource.

I am a nephrologist and I do not have any surgical expertise.  I do not have any expertise in dealing with the surgical management of kidney stones or bladder disease.  Hence, you will need to consult with a urologist, who … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis, Urological Issues

Hi Dr. Spry My husband is 74 years old has stage five for the past 4 months with no symptoms. He also had 6.00 Aneurysm (AAA). He has been treated for UTI for past 5 months. He had 5 UTI been giving a low dose of Antibiotics for only 10 days. UTI always comes back in 3-4 weeks. Now they put him on high dose of 500mg of Cephalexin twice a day for 45 days so they can clear UTI so they can repair the Aneurysm (AVAR). How bad is to use Antibiotics for that long with GFR 10%? Thank you

The dose of Cephalexin that you quote is the proper dose for patients with chronic kidney disease (CKD).  The duration of treatment depends on the type of bacteria being treated and the underlying condition that is causing the recurring infection. … Continue reading

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

My dad was told by the doctors that he has CKD Stage 3 last January. His body as well as his face are really swelling terribly then. He can’t urinate without the help of his medicine. He has been told that CKD is irreversible and only 50% of his kidneys is working. He can’t taste foods, he can’t urinate, and he is swelling. He is often tired even if he is just sitting whole day and can’t even climb even 4 step of stairs. He is so weak physically. But then, around a month ago, he can taste foods again, he can pee without the help of medications and his blood pressure is stable. Swelling of whole body is gone too! Does it mean that he is now cured? Are there any circumstances like this that you know of? Thank you

I am unable to establish a specific diagnosis as to the cause or course of your father’s kidney disease. Stage 3 chronic kidney disease (CKD) does not commonly have any symptoms. All the symptoms that you describe seem to be … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis

I am on chemo. I have interstitial cystitis. I use macrodantin at night and the pill that turns urine orange. Can this protect my urinary tract during chemo treatment? Thanks.

Macrodantin (Nitrofurantoin) is a urinary tract antibiotic and does not have any protection against chemotherapy agents.  The urinary tract analgesic phenazopyridine (Pyridium) turns your urine orange and decrease the pain of urination but has no protection against chemotherapy agents.  

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

I am a 31 year old female with PCKD. My question is how soon can I be put on the transplant list? I have frequent recurring UTIs and kidney stones. My kidney function is still in the 90’s.

Polycystic kidney disease (PCKD) is a slowly progressive disease.  You should not require kidney transplantation until your estimated glomerular filtration rate (eGFR) is less than 20 milliliters per minute per 1.73 meters squared.  The eGFR would need to be less … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney Stones, Kidney-Related Health Questions, Transplantation, Urinary Tract Infection/Pyelonephritis

An MRI showed a complex kidney cyst (4.8×3.9×3.8). US showed the cyst had flow. That was a month ago. The doc asked for a CT scan. That will be done tomorrow. Blood work is all normal and there are no other symptoms. My questions are: do complex renal cysts require surgical intervention or can ablation techniques work? Can complex cysts be monitored over time? Lastly, how serious is this? Thank you

I am a nephrologist and I have no surgical expertise.  I do not perform surgery.  The problem that you pose is a urological problem and is best addressed to a urologist.  A urologist is a surgeon and deals with surgical … Continue reading

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

Hi Doctor, I am a 56 year old female. I’m 5’7” & 165. I have chronic UTI’s and have a urethral stent in my left kidney that is replaced by my urologist every 10 weeks. I must go under general anesthesia for this procedure. I take a daily long term antibiotic and several other medications. Before my last procedure I had a blood test that showed my creatinine level at 1.34 and my EGFR of 45. I cannot have surgery for my urethra because of complications from a sickness in 2013. My body won’t withstand a surgery, from what I’ve been told. My question is, do I have Stage 3 kidney disease and should I be seeing someone other than my urologist with these test results?

Stage 3 chronic kidney disease (CKD) is diagnosed when your estimated glomerular filtration rate (eGFR) is between 30 and 59 milliliters per minute per 1.73 meters squared and has been so for at least three months. The likely cause of … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hydronephrosis and Hydroureter, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis

I am a 72 year old woman with kidney function at 50% from years of IV Vancomycin. In addition I suffer from CRPS which has centralized. I have had a long term UTI. Was just prescribed Macrobid. Am very leery of even starting it based on all my problems. Cipro and Levaquin are out as are all penicillin drugs and a few others.

Macrobid (Nitrofurantoin) is a drug used almost exclusively to treat urinary tract infections (UTI’s).  It is not very effective at all when the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared.  In … Continue reading

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