Hi,
Thank you for your consult at DoctorSpring.com.
As per the history, you have diabetes, hypertension, SLE with lupus nephritis, GERD along with chronic pyelonephritis.
The most common cause of frequent UTI is the inadequate therapy of the very first UTI. As you are a diabetic and must be on immunosuppressive therapy for lupus nephritis, you are more prone for infections. Your tendency for infections keeps you at risk of complications of sepsis as the immune system is inadequate to support you. One of the kidneys got severe pyelonephritis and contracted and other kidney got compensatory hyper trophy. Hydronephrosis of this kidney can be due to UTI and we need to rule an underlying VUR.
Did you ever undergo an investigation called MCUG. For many days you get treated for urine infections? How is your diabetes control? What is your immunosuppressive therapy and I suggest to you that your diabetes should be under good control and immunosuppressive therapy should be the minimum so that the frequency if UTI can come down.
Also you should be under a nephrologist care and monitor your renal functions frequently. You did not mention about s. Creatinine report.
An inflamed kidney can produce hemat iris and protein uric and should not be a cause of concern. However, it is prudent to check for the presence of tuberculosis of the urinary tract as you are getting frequent UTIs.
Hope this helps, please feel free to discuss further.
Regards,
Dr Raju, MD
DM(AIIMS) DNB, FISN, FICP, FIACM
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Patient replied :
family history of lynch syndrome, diabetes, htn, cad, sle, gomerulonephritis. None the these above conditions have been tested for in myself.
I did have a normal mcug. Absolutely no labs except urine for infection. I feel time is of the essence. I want to get on the right track and prevent further damage. Thank you so much.
Hi
It is good that you don't have any such history. You should be under the care of a nephrologist at the earliest and you should be treated for UTI adequately at least once. Get renal functions done and monitor frequently.
Regards