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Ask the Medical Expert Archives 2000-2004

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Loss of Kidney Function
August 2000

Q. One of my kidneys functions at about 20%. For the past 6 months, I have gotten numerous kidney infections. Often times I have dull pain in my back that does not go away. Will my body ever be able to fight off the infections? Will my kidney eventually have to be removed if the pain and infections do not go away? Can anything done to prevent this from getting any worse?

A. Urinary tract infections are a very common cause of the need for medical care and antibiotic treatment. Estimates are that 50% of women will encounter a urinary infection at some time in their lives. In most cases treatment with antibiotics is brief and effective. A smaller percentage of women are prone to recurrent infection and evaluation and treatment become more complicated. Clearly you are in this more difficult situation.

When an infection fails to clear with treatment, or recurs frequently, diagnostic tests are needed to find the reasons for this. In your situation there is a known kidney problem. Diagnostic tests are usually aimed at evaluating kidney anatomy and function (x-ray, computed tomography (CT), and sonograms are common tests), and bladder function may also be evaluated (cystourethrogram). These tests help determine if there is some correctable cause such as a kidney stone or something else obstructing the urine flow. The tests can also determine if an abscess (a localized infection) exists that would require surgical drainage. Removal of the defective kidney may be considered if the tests indicate it is the source of infection, and non-surgical means are ineffective.

HELPFUL WEBSITES:

  • http://www.niddk.nih.gov/health/kidney/summary/pyelonep/pyelonep.htm http://www.healthlinkusa.com/173.html
MEDICAL REFERENCES (usually available through the library of your local hospital):
  • Stapleton A, Stamm WE
    Prevention of urinary tract infection.
    Infect Dis Clin North Am. 1997 Sep;11(3):719-33. Review.

  • Kunin CM: Urinary tract infections in females. Clin Infect Dis 18:1, 1994
    Hooton TM, Scholes D, Hughes J, et al: A prospective study of risk factors for
    symptomatic urinary tract infection in young women. N Engl J Med 335:468, 1996
BOOKS:
  • Stamm WE: Urinary tract infections. Clinical Infectious Diseases. Root R, Waldvogel F, Corey L, Eds. Oxford University Press, New York, 1999, p 649
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