Suggest Treatment For Sleep Apnea And Osteoarthritis In The Knee
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I passed carefully through your recent medical history and would explain that considering your frequent need of urination, an urinary tract infection could not be ruled out easily.
Though the absence of leukocytes in urine isn't too much in favor of an infection, in this regard, it is necessary performing additional medical tests for exploring potential structural and functional disorders of the urinary tract and also an urinary infection.
An urinary tract ultrasound (echo) would be helpful in investigating macroscopic structural components (such as kidneys, ureters, urinary bladder), but it is not able to visualize such microscopic elements like glomerulus. It may explore possible disorder like urinary stones, masses, changes in kidney dimensions, differentiation of kidney parenchyma; it may also raise suspicion of a urinary bladder infection.
But, the presence of protein and glucose in UA may be an expression of a chronic kidney dysfunction, commonly found in diabetic patients.
That's why additional tests are advisable as follows:
- creatinine and BUN,
- creatinine clearance,
- microiological urine culture,
- PCR & ESR,
- complete blood count with leukocytes formula
Only after performing such tests, it would be possible to conclude on a potential urinary tract infection or alternative responsible causes.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
The follow-up showed the protein and blood and no leukocytes.
So, could improper kidney function be due to the recent infection? Or, do we need to suspect hypertension and diabetes, even though both have been under good control with medication?
My answer as follows:
Detailed Answer:
Hello again!
Thank your for the additional information!
You should know that an infection could cause a temporary damage to the kidney cells, thus leading to increased protein and blood.
Hypertension and Diabetes diagnosis can not be based only on a urine analysis. It is true that they can lead to chronic kidney damage, but considering the fact that you have not suffered before from these tow disorders, I would recommend performing further examinations (as above mentioned) to exclude a kidney disorder (including infection or acute inflammation) first.
Regarding Hypertension, is important to closely monitoring your blood pressure values during the day (in sitting position after 10 minutes of total relax). This is a safe way to check if your blood pressure fluctuates during the day.
Regarding Diabetes, I would recommend performing a blood fasting glucose test and HbA1C levels, which would help detect diabetes. Besides, diabetes can also cause glucose in the urine, which was not detected by your urine analysis.
Hope to have clarified some of your uncertainties!
Wishing good health,
Dr. Iliri