Category Archives: Urinary Tract Infection/Pyelonephritis

Hi, I keep suffering with severe flank pain. I was diagnosed with UTI 2 weeks ago after a dip test identified high WBC count and treated with Nitrofuritin for 3 days. Two days in, I had substantial bruising on my thighs for no apparent reason. The nitrofuritan didn’t negate the pain, so I went back to GP 2 days after completing the 3 day course and was placed on a further course. The flank pain had increased during this time and there was a huge decrease in the times and amount of urine I was passing. My body temp during this time kept falling to 35.3 – 35.7 but was erratic and would increase and fall between 35.3 and 37. Three days into the second course of Nitrofuritin, my symptoms did not improve so I returned to GP, who then placed me on Flucox for 7 days. I’ve started to urinate slightly more but otherwise my symptoms remain the same. GP did blood work and advised that my creatinine is 65 and GFR is 90. I’m being referred for kidney scan. My other constant symptoms have been numbness in hands every morning-fingers and hands are ice cold. I have chills and shivering and my abdomen is disproportionately bloated. I have chronic fatigue and flank is very tender. I feel hopelessly lost. I also have Crohns, under active thyroid disease, and chronic muscle fatigue and joint pain and swelling. I have a healthy diet, yet my weight has increased by 16KG during this time (3 years of repeatedly having the same symptoms – minus the UTI). I’d be grateful for any insight?

I am unable to make a specific diagnosis based on the information that you provide. I do not see evidence of kidney disease. If this is a urinary tract infection (UTI), it may be necessary to perform a bacterial culture … Continue reading

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

I am healthy active 82 yo female with recurrent UTI’s and drug allergies. 18 months with rebounding monthly infections. My mother had kidney problems. Urologist’s have not been able to control this. Do I deserve a nephrology workup? Wits end here looking for answers.

As a nephrologist, I have no special expertise in urinary tract infections. A urologist and an infectious disease expert may be more appropriate to consult regarding recurring bladder infections.  If one is available, a urogynecologist would also be an expert … Continue reading

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

Even without infection: Can prophylactic antibiotics be helpful in end stage kidney failure? Thank you.

Prophylactic antibiotics are sometimes used to prevent recurrent urinary tract infections (UTI’s). I know of no other reason to use them in End Stage Kidney Disease. I could not foresee of any benefit to using prophylactic antibiotics in ESKD.

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

I have bladder infection. I’ve gone to the urologist many times,  but the doctor cannot find my problem.  Finally, I did some research on my problem, and I think I have urinary tract infection, based on the burning back pain. How much antibiotic can I take? 

I am a nephrologist and do not deal with bladder disease.  Your primary care physician (PCP) is best trained to diagnose and treat urinary tract infections.  I suggest that you consult with your PCP.

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

I am a 61 year old female who has sustained damage from 25 years of lithium treatment. Although no longer on any such medication since 2003, my GFR is 53 and my creatinine 1.1 which I maintain through an abstemious diet. Concomitant with this damage, I my bladder has hypertrophied to contain over 2,000 ml due to having withheld the urge to urinate in order neither to arrive late to myriad adjunct teaching assignments, nor to leave the classroom. I have, consequently, lost control over my bladder and now wear diapers pads which I routinely soak (such that the urine rolls down my legs, into my shoes, and ultimately onto the floor) several times per day. Are there any physicians who might be able to ameliorate my situation, possibly even either to reverse, or to repair this damage? I have read that lithium damages the renal tubules’ ability to be sensitive to aquaporin. If this is so, is there either an analog or a means through which an exogenous administration of aquaporin, similar to that of insulin for diabetics, available.

I know of no way to repair the damage done to your bladder.  I am a nephrologist and have no expertise in bladder diseases.  Diseases of the bladder and lower urinary tract are within the expertise of a urologist.  Hence, … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis

I recently had surgery for a PUJ obstruction caused by a crossing vessel. First I had a stent in my ureter for 3 months and my symptoms improved then the stent was removed and symptoms returned so I had I laparoscopic pyloplasy 4 months ago. Following the surgery I became very sick and didn’t eat for a week and was vomiting and in severe pain. It was found that I had formed blood clots which created further blockage. This was treated and after 10 days in hospital with intravenous antibiotics I was allowed home. I kept the catheter in for 4weeks after as there was still a lot of fluid coming to the the kidney drain which was removed a further 2 weeks later. I have returned to work now but I have not been well a few times. I am generally very tired these days and sleep about 10 hours a night. I still get very swollen around my right kidney and sometimes don’t urinate much for a few days and then urinate a lot in the night. My face gets puffy when I’m not well and I do get dizzy and fainted once about a month ago. The doctor didn’t find infection in my urine but it was very cloudy. I also get chills sometimes. I haven’t had blood tests recently but about 6weeks ago it showed anemia and inflammation but this was taken as a result of the excessive blood loss after surgery. Please can you give me advice on what to do next?

The problem that you describe is a urological problem.  I am a nephrologist and do not perform any surgery.  You should consult with a urologist, who is a surgeon.  I have no expertise in the situation that you describe.   … Continue reading

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

About 2 years ago, I noticed a change in the frequency of urination. About 6 mo ago, I went to the doc and was prescribed antibiotics for UTI. My symtoms seemed to improve but only for a couple of months. They are back now and include mild constipation, frequent urination especially at night, and if I drink soda, when I wake up in the morning my kidneys feel swollen and hurt. I also notice a urine smell in my underwear.

I am unable to provide a specific diagnosis based on the information that you present.  I suggest that you consult with your primary care physician for a complete examination and further testing.    

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

I was diagnosed with Medullary Sponge Kidney Disease when I was 28. I was full of kidney stones and even the stent put in till I could have surgery because of lack of insurance, which is still lacking because I can’t afford it, made the stent calcify in a matter of two weeks. I follow my diet plan and I reduced my salt intake. I’m so tired all the time and I can hardly sleep. I’ve increased my fluid intake majorly. I feel like I drink more than food intake. Here in the past month I’ve noticed more swelling. Severe pain when bladder is emptied. Kidneys especially the right one aches. I have no energy. Urine smells strong and sweet, its very dark and not a lot of output. I’m drinking 9 bottles of water a day and only urinate 3 times a day. I always empty my bladder before bed as instructed but now I’m waking up for the past 3 months several times to pee. I take a sip of water two hours later I wake up and I feel like my bladder and kidneys are going to explode. I pee a lot and then ache and cramp afterwards. I don’t know what to do. I don’t have the funds for medical help but I’m suffering. My family suffers cause I’m always in the bed aching all the time. Is there any assistance or advice on what I need to do or what’s going on? The only symptom I feel like I’m lacking for kidney failure, is black bile and foamy urine output. Surely I’m too young for my kidney or kidneys to be failing at 31 with just having MSK. But I feel dull aches in my kidneys and painful twinging in my bladder and ureters especially after I urinate all the time. I don’t know what to do. Frankly, I’m scared.

Medullary Sponge Kidney (MSK) can have many manifestations, including stone disease and kidney failure. You can learn about MSK at the National Institute for Diabetes, Digestive and Kidney Diseases (NIDDK) web site at: I am not able to make a … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Medullary Sponge Kidney, Nephrologist, Urinary Tract Infection/Pyelonephritis

Dr. Spry, My father suffered a kidney failure, apparently resulting from a UTI this past March. Though he is a long-term diabetic (over 27 years), his medical records state his condition as AKI rather than CKD. He is now dialysis-dependent, but his doctor seems to believe his kidneys could recover sufficient functionality for him to go off dialysis, though it’s been nearly 8 months since the diagnosis. What indicators would a doctor use to identify AKI vs CKD in a less obvious scenario where the UTI or the Diabetes could be the root cause, unlike an actual physical injury or nephropathy in the absence of a pathogen beyond diabetes, where I presume it would be easier to classify as AKI or CKD, respectively. How would the doctor determine if there is a possibility for some kidney function to return? From what I can tell of his creatinine, potassium, urea, albumin levels, there doesn’t appear to be a consistent improvement in any metric that would allow a quantitative assessment of kidney recovery. Is there a qualitative method to assess the viability of a kidney? Short of a biopsy is there another quantitative method outside the typical blood work to judge how much kidney function is just dormant vs. how much has been lost permanently? Apologies for the multiple questions! My father is being treated at the top hospital in his city, one well-known for international medical tourism (though he’s a local). His doctor appears to be a very competent and straightforward professional. Unfortunately, doctors in India are extremely reluctant to share technical patient information and I’m relegated to scouring the internet to help my dad navigate his condition. Thank you for any information you can share on the subject!

Acute kidney injury (AKI) means that the tubules of the kidney have been injured but the filters of the kidney (glomeruli) remain intact. If there is tubular injury, then the kidney is capable of repairing this injury and then the … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis

Hello Dr. Spry. Is UTI more likely in a male if the pH of urine is greater than 7?

A very high pH in the urine can be a sign of bladder or kidney infection with certain types of bacteria. You will have to have the urine tested for infection in order to determine if a urinary tract infection … Continue reading

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