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Urinary Disorders

Chronic Kidney Infection

07/09/2009

Question:

I will give you a little of my history before asking my question in hopes it will better your response. I am a 35 yr old female. In 2006 I had my left kidney removed due to always having a chronic infection that would not go away and my kidney shrinked to 10%. It was around 30% in 2006. I was always ill. After removing, I physically felt very good for 2 years. The pathologist report came back as incurable infection. Now I am experiencing the same with my right kidney minus the shrinking. I keep getting severe kidney infections that even landed me in the hospital this past Sept. I have been on medication for now 6 months and I still have the infection. I am seeing a different doctor with this kidney. They are going through the same procedures that were taken with my bad kidney. My question is, what exactly does incurable infection in kidney mean? If this is what I have in my only kidney, will I not ever be able to rid of it? I very much appreciate you taking the time to read my question and your response will be greatly respected. Thank you.

Answer:

Your kidney situation is worrisome. When a person has repeated or constant kidney infections despite treatment with appropriate antibiotics for an adequate length of time (and 6 months should certainly be adequate for eradicating an infection), there is often a structural problem that allows (or even encourages) bacteria to grow in the kidney, causing serious infections and destruction of the kidney. For instance, kidney stones can cause infection; there can also be abnormalities of the ureter (the slender tube that drains urine from the kidney to the bladder), causing urine not to drain properly, or even to flow upward from the bladder back into the kidney. Studies can be done to detect these abnormalities, and it sounds you may have had at least some of them already: renal ultrasound, CAT scan, voiding cystourethrogram, cystoscopy.

If the infection cannot be cured in your remaining kidney, you may end up losing that one too. So it is important for you to be very closely followed by both a medical kidney doctor (nephrologist) and/or surgical kidney doctor (urologist), and also for you to take all antibiotics as instructed, and to seek medical care every time you have even the slightest symptoms of a kidney infection.

High blood pressure may develop with the type of kidney disease that you apparently have, and the nephrologist should monitor your blood pressure and treat it if needed: poorly-controlled hypertension can accelerate the rate of kidney damage. Also, be sure that you ask your doctor to explain whether your kidney function is still normal; and if not, what percent of your function you have left. Finally, be sure that the results of your imaging studies are discussed with you; if something structurally wrong is detected, it may possibly be repairable with surgery. Best of luck to you in this serious situation.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University