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Thursday, July 31, 2014
Kidney Pain at 3am for Ten Days
Female, 52 yrs, hospitalized ten days 30 yrs ago severe kidney infection, approx 15 UTI`s since then, none in the last 5 yrs.
Mid October had cystitus and did 3 days (Nuproxin?) which cured but since then had odor and cloudiness in urine.
Had annual physical and asked to check was told no infection. At follow up Nov 28 I told doctor about intense pain that wakens me at 3am. for last 5 days. They cultured and called Dec 1, said take Cipro for two weeks. I started it that night.
The odor has faded and urine is less cloudy after three pills but both nights I am wakened with horrible pain at the same time. When I get up to urinate there is no cystitus type pain but when I finish the kidney pain is intensified. Heat comforts but does not change pain. Sitting up is better than lying down. Otc`s do nothing. After several hours sitting up it fades enough for me to walk upright but if I push in on left kidney from front or back it intensifies. No fever, even low grade. My question is what is with the exact timing of the pain??? And why no decrease since starting atibiotic?
I cannot give you definitive answers to your questions without knowing more about you (would have to see you, examine you, and review your labs and imaging studies). But here are some thoughts that may help, and that may give you ideas of questions to ask your doctor:
1) When you say you have "kidney pain," is it truly from your kidneys? Below is a link to our article about kidney pain, which should help you to know for sure whether your pain is actually originating from your kidneys (as opposed to your bladder or muscles in your back). If it is truly kidney pain, this is very concerning because it suggests that there is a source of infection in your kidney(s), and until the source is eradicated, the infection cannot be cured.
2) The pain you describe at the end of urination is interesting. Again, the question is whether or not it's coming from the kidney. If the pain is in the lower part of the abdomen it's most likely related to irritation of the bladder muscles, which contract particularly at the end of urination.
3) In any case, with your history of so many infections, it would be interesting to know what your imaging studies (such as ultrasound, CT scan, or MRI) have revealed. Is there evidence of kidney scarring from past infections? Is the kidney structure abnormal in a way that would allow bacteria to hide and grow, and not be normally washed out in the urine? If there anything in the kidney such as a kidney stone that may be causing pain, cloudy urine, and providing a place for bacteria to grow?
I hope these thoughts help. Please write again if you have more questions!
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University