Pain after EWSL

Hello,
I had surgery on my left kidney in 1988 for a birth defect (urerter and veins twisted up and obstructing flow out of my kidney).  After surgery and IVP the urolgist said my function was 85% in the left kidney and right kidney was completely normal.  16 years have passed without a problem.   In April 2004 I got a urinary tract infection that would heal up after a week of antiobitotics, but continued to return.  After three rounds of this, I saw a urologist who had me get a CAT Scan that showed I had a 3 cm stone in the renal pelvis of the left kidney, multiple mini calcifiations as well and a small stone in the outer pole of the right kidney.  He cleared up the infection again and then I had lithotripsy on the left kidney.  Two weeks after, on the KUB xray the stone was gone.  I had a lasix renal scan two weeks after then and it show no obstrution or mechanical problem, but did show the the left kidney now only had 15% function.  The right kidney was fine.  The doctor put me on one low dose antibotic (antibiotic) a day for two monthes and I am  to see him again in Oct.  My question is this, until I had the lasix scan, I had very little pain in my left flank.  About a week after the scan, I stared noticing soreness deep inside the left flank.  The doctor assured me this was most likely from the EWSL as well as the renal scan.  He said he wasn't too concerned about the pain unless it brought fever, remained constant or was continous.  At that point he would consider wether he would have to remove my left kidney.  I never had any pain the entire time I had the infection or stone, or even after the lithotripsy other than soreness.  Could something have happened to my kidney during the renal  scan to injure it?  Or does it take a long while for the pains to be gone after this kind of procedure?  Or is the pain I feel from the kidney going bad?  I am scared of losing my left kidney or getting a bad infection once I am off the antiobiotics.  But maybe this is normal and the healing time takes several monthes?  I notice the pain is worst after I have done alot of physical work.  Your advice on this would be greatly appreciated.  Also, they said my stone was from Calcium Oxalate and told me to go on a low oxalate diet, which I have been.  But Carbon Apatite was also present in the stone, which I read indicates parathyroidism.  Is this any truth?  Do I need to be asking for more tests?  I did just recover from thyroiditis in July.  I'm just very concerned about the intermittent soreness and pains in my left side.  Thank you.

[Kevin Pho, MD]

To answer your questions:
1) I am unaware of the renal scan decreasing the kidney function to that extent.  It may be possible the contrast material from the test may have affected kidney function.  

2) The time it takes for the pains to subside would depend on what is causing it.  Also, it would depend on what disease process is affecting the kidney function.

3) If there is increased calcium in the urine, sometimes thiazide diuretics are used as a preventative measure.  If parathyroidism is a concern, a parathyroid hormone level can be measured via a blood test.  

As for the kidney function, it is difficult for me to say what is causing it without reviewing your chart.  If there is no structural or obstructive problem, then you may want to consider a referral to a nephrologist (kidney specialist) to see if there is any intrisic kidney disease causing the problems.

You may want to discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[DonnaD54]

A related discussion, ESWL Therapy was started.