Category Archives: Urinary Tract Infection/Pyelonephritis

About 6 months ago I started to have no control of my bladder. I’m a truck driver and when standing my urine just flooded out. I saw a urologist, he had me try a prescription but I had little success. A lot of the time my urine has a very bad “fishy” odor & is very cloudy. I drink diet cranberry juice and 8 to 10 glasses of water every day. I’m a diabetic, (A1c 6.4) & HBP. Last Dr. visit I was told I was in stage 3 kidney disease. She assured me this was normal in my age group, 64. I’m very concerned regarding the “fishy” odor and cloudiness. It does get better when I get off the truck for home time. Should I see a kidney specialist? Thank you for your time & attention!

The problem that you describe is a urological problem. I am a nephrologist and have no expertise in the treatment of bladder or lower urinary tract disease. I suggest that you continue to consult with a urologist or a gynecologist. … Continue reading

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

Sir, 6 months back I had a stone in the right kidney, size 11mm. The stone was crushed and removed through urinary tract. That time my creatinine was slightly high, 1.5. After removing the stone, creatinine become normal. After a few days, I had a UTI and my creatinine went to 1.5. I took the medicines for the UTI and the creatinine went back to normal. 16 days later, my creatinine increased; the reading was 1.25 (reference- 0.6 to 1.1) and there was infection in urine. I took antibiotics. After 10 days of antibiotic course, my creatinine is 1.27 (ref- 0.6 to 1.17), and my TSH is 7.98. I have been suffering from High Blood pressure for the last 38 years. At present, I am taking Cilacar M and Cilcar 20 mg at night. Previously I was taking Telmasartin 40 mg + Amlodeepin 5 mg combination. But after the slight increase of creatinine, the medicines have been changed. I always feel dehydrated and burning in my urine. At night, I have to go to bathroom nearly 8 to 10 times to pass the urine, but day time I am OK. Please advise sir. What precautions should I take to protect my kidneys. My BP is around 130/90 or 140/85.

I am unable to make a specific diagnosis based on the information that you present. I am unable to offer medical advice without being able to perform a complete history and physical examination. Your symptoms are concerning for lower urinary … Continue reading

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

: Hello, My GFR is 28 currently. When I was 20, I had toxic shock syndrome and was on dialysis for a few months and regained about 80% of my function back. I lived a normal life until 2009 when my function changed and I was told I was stage 2 kidney disease. And then about 2013ish I was I was stage three. Just recently I had to have a heart test that used dye and it seems to have changed my GFR from 39 to 28, so I been told. So, as of last month my GFR is 28. During that doctor visit my kidney doctor stated that my urine test had blood and that I needed to see a urologist. The kidney doctor states that it could be something with my bladder. So, an appointment is scheduled for June to see a urologist. My question is if I am now stage four isn’t finding blood in my urine one of the symptoms of stage four? And I asked if it could be from my kidneys and he said no. So, I am confused. Maybe I misunderstood what the doctor said or meant. Can you help? I know you don’t know my history and I tried giving you what I thought might help you without boring you to death…lol thank you.

Isolated blood in the urine as a new finding is not a characteristic of chronic kidney disease (CKD). Blood in the urine most commonly comes from the lower urinary tract rather than the kidneys. Hence, I believe it is entirely … Continue reading

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

Hi, I’m having pain urinating, occasional back pain and low grade fever. The doctor prescribed Ciprofloxacin tablet for 5 days and Epimag. I finished the antibiotic but I still have fever. My urine test result pus 6-8, rbc3-4, epithelial cells++, and specific gravity 1.015. My urine culture is negative. Please help me. I’m confused. Thank you.

I am not able to make a specific diagnosis based on the information that you present. Your symptoms suggest a urinary tract infection but if your urine culture is negative for growth of bacteria, then further testing will be required. … Continue reading

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

Hi Dr, My father, aged 55 years, was on dialysis for 6 months and has gone under kidney transplant on 24 April 2019. Post transplant his creatinine level is normal, blood levels is around 10 + (Rbc). Small Bladder ( 80ml). All reports are normal. However, he is facing two issues: Tac Levels are around 4 post transplant (Increased dose, but levels are around 4 only). Recently put on cyclosporine (Test results are awaited). Second issue frequent urination (every half an hour 100ml) may be due to small bladder. In his urine culture, Klebsiella Pneumoniae is intermittently found. Around 60,000 bacteria count. Any suggestions will be helpful.

I am not able to make treatment recommendations without performing a complete history and physical examination. The Tacrolimus levels that you mention are commonly kept between 8 and 12 nanograms per milliliter (ng/ml) immediately after transplantation. This drug is commonly … Continue reading

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

My daughter has been dealing with severe UTI symptoms for years but every tests show no infection. She was told she has an undeveloped ureter years ago and the doctors wanted to send her to another hospital to be evaluated further. She was a single mom and couldn’t get to the specialist and now the record is missing from the original tests. She is very headstrong and won’t listen to me about the test results. Can you please tell me what the name of this condition is and any symptoms that a blocked ureter would cause? The odd thing is the doctor told her she needs a transplant and I have an extra one that is a viable ureter. Any help would be appreciated.

The question that you ask is a urological question. I am a nephrologist and do not have expertise in the bladder or ureters. I am not a surgeon. A urologist is a surgeon. Your daughter may need to see a … Continue reading

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

Hello sir, My mom is suffering for a year now. In the last few months (June-18 to Now) she got hospitalized for 3 times and the diagnosis ended up with kidney infection. Her recent (Non-Contrast) CT scan and MR urogram report say’s “Bilateral chronic renal parenchymal disease with mild atrophic change in right kidney and mild hydronephrosis in left kidney”. Before she was hospitalized for first time in June, 18 , she had severe cough, fever, metallic taste and pain for 6 months. After hospitalization in June, 18 she was diagnosed as a case of (AKI due to) UTI and treated with 【MEROPENEM 1gm I/V】3 times a day for 7 days. Her test results are : ◆ 1.both blood and urine culture was positive for E.coli ◆ 2.USG whole abdomen : { ●Kidneys: Both kidney’s are enlarged & swollen. Cortical echogenicity of both kidneys are increased. Cortico-medullary differentiation is ill-defined. PC system are not dilated. ●Urinary bladder: Partially filled. However, balloon of Foley’s catheter is seen in situ. ◆IMPRESSION : Bilateral acute renal parenchymal disease.} ◆ 3.WBC Count : ●Highest : 18.72×10^9/L ◆ 4.Creatinine : ●Highest : 1.8 mg/dl ●Lowest : 1.8mg/dl Again after a month in July, 18 she felt severe pain, nausea and high graded fever at midnight (while this time she took a diclofenac suppository) and got hospitalized. Then she was given wrong treatment by giving her 4 dose of Ciprofloxacin 500mg (Which is resistant on her) in the hospital. Later on hospital’s internal medicine department handed over the case to nephrology department and they diagnosed DM, CKD, repeated UTI and Acute Pyelonephritis and treated with Meropenem 500mg I/V daily dose for 14 days also prescribed ◆Cotrim (Sulfamethoxazole-Trimethoprim 400+80gm) 2 tablets daily for life long.【This time her USG report says about Debri】Her test reports are : 【◆UGS whole abdomen: – ●Kidneys: Both kidneys are swollen. Cortical echogenicity of both kidney’s increased. Cortico-medullary differentiation is maintained. PC system of left kidney is mildly dilated. ◆◆◆Urenary bladder : Debri are seen in urinary bladder. 【◆◆◆IMPRESSION : ◆ Debri in urinary bladder ◆◆Bilateral swollen kidney with increased cortical echogenicity and left sided hydronephrosis-? pyelonephritis -clinico- pathological correlation please】 ◆ 1.Non Contrast CT scan : {●Kidneys: Both Kidney’s are enlarged & swollen, more on left side. Fat striation is seen around the left kidney. Left PC system is prominent. ●Ureters: Both ureters are not dilated. *Small fluid collection is seen in pelvic cavity **Partial collapse compression is seen in L1 vertebral body 【◆IMPRESSION : Bilateral pyelonephritis with small fluid collection in pelvic cavity 】} ◆Again both blood and urine culture results were positive. ◆Urine R/M/E : Pus cells- 25-35 HPF ◆S.Creatinine : gradually decreased from 7.3 > 2.37 mg/dl. Again in Nov, 18 with the same complaints but this time she had a heart attack and got hospitalized. Then the doctors diagnosed her with CKD and and UTI. Again she got a 21 day long Meropenem 500mg I/V daily dose. Also she got 2 sessions of dialysis as her creatine level got to 9.8 mg/dl which then decreased slowly to 5.0 mg/dl. This time she got an MR Urogram and a non-contrast CT scan. Both the reports says, “Bilateral chronic renal parenchymal disease with mild atrophic change in right kidney and mild hydronephrosis in left”, As I mentioned in the first para. Now her creatinine is stable at 4.2 to 5.0 it decreases if the infection reduces. But the infection does not treat all over. Doctor is saying they can’t find any solution and the main reason of infection. They told us that my mom needs to take antibiotics whenever the infection raises, beside this there is no way. Still then she got another 4 week’s of antibiotics dose but the infection is not healing. I suspect that my mom have vesicouteteral reflux. I went to the best doctors of our country but they all are the same. I want to know what could be the solution for this?

I am unable to establish a specific diagnosis and treatment plan without performing a complete history and physical examination. Your mother appears to have a complex medical illness complicated by recurring infection and acute kidney injury requiring dialysis. I can … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis, Urological Issues

My dad is 82 years old with bph, has a indwelling foley catheter. Over a few weeks his catheter has been leaking and had saturated his diaper. Nurses have changed out the catheter. Only for it to start leaking again. This has happened a lot. He has a history of UTI’s. He ended up in the ER with septic shock secondary to UTI and pneumonia. Renal failure and respiratory failure. He also had a clogged catheter. My question is at what point do you call for a urology consult? And how do you prevent septic shock?

Problems with the lower urinary tract are within the expertise of a urologist. I am a nephrologist and do not deal with Foley catheters and complications. If there are problems related to infection and a bladder catheter, then urologic consultation … Continue reading

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

Greetings. My question concerns my wife and trauma she received just over a year ago. On December 17, 2017, she and my son was involved in an automobile accident. A lady talking on cell phone made a U-turn and pulled directly into their path. My son’s foot was injured severely and my wife had tremendous upper chest and abdomen injuries due to seat belt. Both were taken by ambulance and treated at nearby hospital and released. Couple of months later, latter part of February, 2018, my wife began to become ill and was diagnosed with a urinary tract infection and treated with antibiotics. After about a week and no improvement, I had to take her to emergency room as she was very sick. Ultra sound and X-rays revealed a kidney stone had blocked ureter and she had become septic. Emergency room doctor made decision to air lift her to a hospital in different state that was better equipped to handle her condition. She spent about 10 days in intensive care. Dismissed from hospital and had to return and was readmitted due to complications from sepsis. This was in early March, 2018. Now, one year later, she is beginning to get back to normal with just a few minor lingering complications, she lost her hair due to stress on her body, it is now growing back, she has a terrible cough due to intubation. Her health insurance has been wonderful with the exception of the air flight. Her insurance says the flight was an out of network provider and we are looking at a bill in the 10’s of thousands of dollars, they started with a $39,000.00 bill for a less than one hour flight. Her health insurance paid $4300.00 on the flight, we are responsible for balance. Now to my question, would and could it be possible for the damage to the kidney and subsequent kidney stone and sepsis be related to the injury from the accident just about two and one half months earlier? Our automobile insurance will pay for the air flight if her condition was or could be related to the automobile accident from December 17, 2017? Thank you so very much in taking time to review my question and concern. Sincerely.

I am unable to make a specific diagnosis without performing a complete history and physical examination. It would be best for her primary care physician (PCP) or a physician who cared for her during her illness to render an opinion. … Continue reading

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

Hello. For the past two weeks I’ve been having moderate to severe pain in my back on the left side only below my ribs. The first time this pain appeared was on a Saturday and lasted for 4 to 5 hours. The pain was very intense to the point where I was in tears but I was unable to leave work to go to an ER and the pain had decreased to a moderate pain by the time I left work. The next day the pain intensified again lasting 3 hours before going to the ER. While in the ER the doctor had not taken any imagining only a urine sample, blood draws and provided Torodol via IV. After the UA was complete I was told it appears to be a UTI; was giving a prescription for antibiotics and sent home. I followed up two days later with a family care PCP [not my primary as she is not available right now] who did not do a physical exam and said he did not believe my issue to be a UTI. That doctor did x-ray imaging of my back to rule out any skeletal issues. The x-ray came back to show only minor degenerative disc disease. Another blood draw and UA was done at the appointment. A few days later the doctor called and informed me that my creatinine levels had risen and would like to follow up a week from the previous appointment. At that follow up he expressed concern about kidney function but brushed it off due to my age. My mother-in-law is a RN and has also expressed concern for my kidneys. To date no imaging of my kidneys have been done. Also, the day before my follow up the intense pain had returned but was not only in my back/flank but in my upper abdomen. It felt like a tearing pain under both ribs and there was a throbbing under my ribs in the center of my upper abdomen, you could both feel and see the physical throbbing. This pain again was sudden but was also episodic, coming in waves, lasting between 2 and 10 minutes at a time for 3 hours. I did not go to ER at that time due to having an appointment the next day. Though I admit now I should have gone as the pain was also in my chest and it was difficult to breath during the points of intense pain. I am 31 years old, transgender (FTM), with high blood pressure; I’ve been on BP medication for less than 1 year even though my blood pressure has been elevated for years, and overweight (5’1, 220lbs). In this time three blood draws have been done in order or draw my creatinine has been 1.36, 1.39 and 1.26; BUN has been 10, 10, 11 making BUN/Creatinine Ratio 7.4, 7.2, 8.7. My question is, if this is anything to have concern over and to seek out a nephrologist’s assistance. I have not been confident in the doctor’s actions the two times I have seen him but do not know what to do next. Thank you for any guidance you are able to provide.

I am not able to make a specific diagnosis based on the information that you present. I also think you need further testing that might include a helical computerized axial tomogram (CAT) scan and looking for kidney stones. An ultrasound … Continue reading

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