Reduced kidney function


#1

Hello

I’m not sure if this is something I can ask on here but I’m not sure where to go…
I’m a 44 year old female, I’m currently under the care of a renal specialist and after several tests I’ve been told I need to go on 12 months of antibiotics! I’m considering a second opinion!
I’ve had many years of gynae issues with many UTIs. I had a hysterectomy in Aug 2017 which resolved the underlying problem of adenomyosis. I had quite a lot of UTI’s when I was a child, it was looked into and nothing came of it! I had an u/s which showed enlarged left kidney, further tests showed a puj with chronic infection and inflammation and renal scarring. A renogram showed 30% function in the left kidney. The specialist went in under GA yesterday, he found the blockage now clear but noted my bladder was twice the size it should be, nothing further was said about the bladder or any link noted between the kidney and bladder. The urologist said he was confused by all the results and thinks 12 months of antibiotics will help! I’m not happy with this as a quick google search links an enlarged bladder to problems with kidney function! Any advice/help would be very much appreciated. I feel extremely tired most of the time and have symptoms of UTIs permanently so this is really affecting my quality of life. Thanks in advance


Kidney function advice
#2

It sounds like you may have had reflux as a child. This can happen when there is a narrowing or blockage in the ureter, the tube from the bladder to the kidney, or in the urethra, the tube through which urine flows out of the body from the bladder. Correcting that can help resolve reflux. It sounds like this wasn’t discovered for some time since you say you have some kidney scarring.

Here’s an article on preventing UTIs in case any of these suggestions are helpful in eliminating other causes.

To know how well your kidneys are functioning, you need blood tests. You might want to read the Kidney School Module 7 Understanding Kidney Lab Tests to see what tests to ask for.
https://www.kidneyschool.org/mods/

You mention bladder pain. Here’s an article on the causes and treatments of bladder pain. You might want to discuss this with your doctor.

Using antibiotics long-term can have risks. If you’re not happy with the doctor’s recommendation, getting a second opinion is always an option.


#3

Thank you so much for your reply. Reflux was mentioned at one point to me. I’m definitely getting a second opinion next week.
If possible could you let me know how reflux would be corrected?
Thank you again for your reply, very much appreciated


#4

Ask the doctor if the condition you have and that he/she treated with surgery to remove a blockage was for is reflux. Assuming reflux is the condition you’ve been dealing with, here’s an article from a U.S. government website on reflux that often occurs in children. The article lists causes, treatment options, and prevention tips.

Here’s a Mayo Clinic article that discusses diagnosis, treatment with surgery and with antibiotics at lower than usual dosage to prevent infection.
https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/diagnosis-treatment/drc-20378824

Repeated infections can damage kidneys. Ask your doctor what your estimated glomerular filtration rate (eGFR) is. This can be calculated from kidney lab tests. There are online GFR calculators like the NKF one at https://www.kidney.org/professionals/KDOQI/gfr_calculator.

Urologists treat conditions of the urinary tract. If you have chronic kidney disease, I’d suggest you consult with a kidney specialist (nephrologist). There are many things you can do to help to slow progression of kidney disease. Here’s information that may help. https://lifeoptions.org/learn-about-kidney-disease/


#5

Thank you again for your response and information.

I’ve no idea what the issue is, only that initially a puj obstruction was noted with renal scarring and chronic infection with enlarged kidney.
I had a renogram which showed 30% left kidney function so the specialist did a endoscopic retrograde pyelography. He said the blockage was no longer there so gave my kidney a huge shot of antibiotic, he noted a huge bladder, twice the size it should be. He’s doing nothing further now other than oral antibiotics for 12 months.

I’m confused re all the previous findings a few weeks before on the scans. I’m definitely going ahead with a second opinion on this.

Thanks again for all you help, it’s very much appreciated.


#6

Here’s a booklet for patients and their loved ones about a PUJ obstruction. I’d heard of obstructions, but not ever heard that terminology.

The bladder fills and empties several times a way. If the bladder fills and it can’t empty like it should, it can cause the bladder to stretch and become enlarged. Did the doctor check for narrowing of the urethra (the outlet tube) too? I have a friend who has had several UTIs because of narrowing of the urethra. I believe the doctor treated that by dilating the urethra. From what I’ve read, having an enlarged bladder is not uncommon, but any underlying cause of the enlarged bladder needs to be treated to prevent complications.


#7

The surgeon told me the endoscopy could widen the urethra which might help with the symptoms.
As I only had it done two days ago I’ve not noticed any improvement as yet. He mentioned the enlarged bladder in passing, his only comment regarding this was that I must hold my urine sometimes which has stretched the bladder! I don’t do this and never have! My worry is the enlarged bladder has caused the reduced kidney function or vice versa. I really feel my issues need further investigation rather than just prescribing me with 12 months of antibiotics. I’m definitely going to see a different specialist for a second opinion. I’ll take a look at the information you have sent me. Thank you again for all your help, it really has helped me gain more knowledge in this area.