Hello, Thank you for asking at HCM. I carefully read your question and understand your concern. There are a couple issues that might happen in a chain of events. First: if you have structural abnormalities of the kidneys like ectopic ureter, reflux, duplicated kidney and ureter; this might favor urinary tract infections and kidney infections also. Second: having frequent urinary infections favor kidney function alteration on that side. Also structural abnormalities of the kidneys and urinary tract might bring kidney function alteration. Fatigue and confusion might be signs of kidney function problems and you will need to have a blood creatinine checked. If it is 1 and lower than your kidney function is good and symptoms are coming from something else. Another good test to do is Complete Blood Count. Somentines when kidneys do not work well we get anemia induced by lack of an enzyme that kidneys should produce. So in your case I would recommend you a blood creatinine and complete blood count test. If the results are normal, than the symptoms are not from kidney. If you have one good kidney generally it is enough to cover for the other one also. People with one kidney do fine and have no problem as long as the good kidney is working well. I would also recommend you to have regular urinalysis and urineculture- both are urine tests to check for infections so you detect them earlier, before they get too advanced and treat them on time. Sometimes it is recommended to get regular antibiotic use daily of long time to prevent the infections. You will need to discuss these options with your doctor, that is already following you up and treating you. Make sure you drink plenty an see you doctor for any urinary symptoms or concerns. I hope this is helpful to you and answers to your question