Question: Hello,

The last 4 days I've had the symptoms below.
For about 2 weeks prior to that, I had symptoms
that suggested UTI or prostate problems. Had
urine culture and urinalysis that ruled out UTI I guess.


Symptoms:

     - extreme dark circles under eyes even after sleeping well for weeks on end
     - low/mid back pain, mostly on the left pain, in the rib area
     - pain worsened after eating salt
     - pain worse at night. Seems the longer I'm in bed, the worse the pain gets
     - nausea
     - weight loss, even though diet has not changed much. I'm currently 140 lbs
          at 5 11 in height. Its been going slowly down since 2012, when I
          first started feeling sick.
     - metallic taste in mouth at times
     - very foamy urine
     - increased urination at night
     - sleep disturbances
     - for a while, had pain on urination
     - pain in hips, lower stomach and pelvis(think it's prostate related)
     - headaches

     - several days ago, the symptoms got much worse after over eating,
     and eating 2 large bowls of sugary cereal the previous day(usually
     my diet is very good, though). Sleep has been very bad as well,
     so I took more and more herbal supplements to help sleep, which
     made me feel sicker. Last 2 nights I only got 4 hours sleep and
     I feel awful.

Recent tests:

     - Urine culture/urine analysis in last few weeks: both normal

     - CBC/CMP in the last 6 weeks: both normal except slightly low
          red blood cell count(it's been that way for about 3 years now)
          and BUN/Creatinine ratio was a bit high

     - no diabetes

     - I've had abdominal scans/ultrasounds in the last 3 years, but none
     in the last year. Results were mostly normal except left kidney had
     some cysts.

Lifestyle:

     - I know I take too many supplements and eat too much protein.
     Very recently I've tried to but back on both

- What possibilities could explain all this? Kidney problems come foremost
to mind, but standard urinalysis and blood tests come up fairly normal. What
other things might account for this?
     Also, last fall I went to the Emergeny Room with the same symptoms.
They initially thought it was a kidney stone, but after taking xrays of the area
and running blood/urine tests, they said my kidneys were fine. The ER doctor
then suspected it was just intestinal inflammation.

- What additional tests can you recommend? I'm thinking of the following:
     - KUB Ultrasound
     - ultrasound of abdomen, especially to check the pancreas
     - Cystatin C test(more precise measure of kidney function)
     - Microalbumin test(more precise measure of kidney function)
     - Lipase/Amalyse
     - possibly tumor marker tests, like CA 19-9
Any others that might get to the bottom of this?

- Could I have a kidney infection even when all urine and standard
blood tests are normal and I have no fever?

- What can you suggest to help alleviate my symptoms, especially
the low/mid back pain at night(which is costing me sleep)? I've tried
cold packs(which help), and heat which helps slightly. But these can't
be applied throughout the night when I'm sleeping. Also NSAID's and
other pain relievers are very bad for the kidneys, I've heard. Would a
sitz bath or shower shortly before bed possibly help with this mid-back
pain?

- What nutritional changes would provide the most/quickest relief,
assuming it is my kidneys that are the culprit?

- I have an in-person doctors appt on March 25. Do you think, given
my situation, that I can afford to wait that long, or should I go to the
Emergency Room if symptoms persist or worsen?


Thanks,
XXXXXXX

Thanks Doctor.

I have a few followup remarks and questions.

Since this latest incident about a week ago,
I made the following dietary changes to
try to improve my kidney health. But now
I feel weaker and more anemic than ever
before. Can you read over this then give
me some specific advice?

- Limiting Protein/Meat:
          - I read that high protein, especially meat, is the worst
          thing for the kidneys, so in the past week(ever since the
          incident I told you about), I've reduced my protein intake
          by about 1/3 and am using a vegetable protein drink in place
          of meat for some meals.

- Limiting Potassium and Phosphorus:
          - I've read that things like white rice are better for the
          kidneys than brown rice, because they contain less of
          these. So I've been eating lots of white rice lately.

          - since a lot of vegetables are high in potassium and phosphorus,
          I've eaten less of them in favor of fruits like berries, watermelon,etc
          that are low in these.

- Water Intake:
          - I've increased my water intake, because some say it's best to
          drink as much water as possible,but others say that puts a strain on the kidneys.
          What is your opinion on this? Should I increase or decrease
          my water consumption(I used to drink about a gallon a day. Now its even more)?

In order to take the recommended tests asap, I will need a doctor's
order for these. Is it possible for you to provide one? Would it be honored
if it came from a doctor from another country?

Also, I'd like to keep this discussion 'open' until I get the test
results back, which might take a few weeks. Is that possible too?

Thanks so much,
XXXXXXX