Suggest Treatment For Recurrent UTI And Presence Of Protein In Urine

Posted on Mon, 31 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 31 Aug 2015 Answered on

Mon, 21 Sep 2015 Last reviewed on

Question : Hello Doctor ,

I have a Kidney transplant History.
from April , XXXXXXX and latest was july 16. I was confirmed with 3 UTI , every time different bacteria . The Latest was e-coil which was detected on July 16th

I was Put on Niftas for 2 weeks 1-0-1 and then later for one month 0-0-1. Also i am currently Taking UTI Off Tablet for 3 months

out of whcih one month is almost over.

At the time of infection it Creatinine was 1.6 now it has come back to 1.4 . But before infection it used to be 1.3 or 1.2

Now , my concerns is when i check for Urine Report , it is showing protien as ++. and i m concerend .

i am going to meet my nephrologist on 15ht Sept.

Can you let me know what might be the reason for Protein ++ in urine ?

i still can feel the burning sensation when passing urine but the culture reports say no growth.

Thanks
XXXX

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Need not worry about proteinuria

Detailed Answer:
Hello

Thanks for the query

Protein loss is known to occur when patients have urinary tract infection. I suggest you to get a 24 hour urine protien once the urine culture is free of bacteria.

I also suggest the following things

1. Get an ultrasound of the transplant kidney and also bladder with post void residue. This is to know the cause for recurrent UTI
2. You are on very high dose of wysolone which could be contributing factor to your UTI. I usually reduce Wysolone to 20 mg by two months post transplant. Please speak to your nephrologist about this

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (3 hours later)

Hello Doctor.

my culture reports has come and have attached it . shows there is no growth.

But Protein is still showing as ++ . still concerned .

Ecoil was detected on 16th July . i took niftas for that.

its almost 1 months now , and showing now growth in urine culture.

But Protein i urine ++ is the concern.

Pls suggest.

Thanks
XXXX

Answered by Dr. Rakesh Madhyastha (16 hours later)

Brief Answer:
Not to worry

Detailed Answer:
Hello

Thanks for the query

Persistence of proteinuria can be there for 2-4 weeks after an infection. I must point out here that the protein loss could be from your native kidney as well and does not always mean recurrence

However I would like you to get the following tests done as further evaluation

1. 24 hour urine protein and creatinine
2. Ultrasound of the transplant kidney

I must point out here that since your creat is little on the higher side and there is some amount of protein loss, a kidney biopsy would add wealth of information. Please speak to your doctor with this recommendation of mine

The best way to tackle protein loss is by being ACE/ARB, I usually prescribe Tab Telmesartan and titrate the dose to the best tolerated dose in terms of normal potassium, adequate blood pressure and reduction in protein loss

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar