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casts and crystals

Beginning in Oct I had a severe uti treated with Leviquin after a week there was casts and crystals in urine so I was put on cipro for 3 days with no help so was given bactrum  for a week not better, I went to another dr and was immediately given high dose of cipro for 10 days with the casts and crystal still there but lower amounts.  Was put on Microbid for a month and still casts and crystals in urine.  Done kidney ultrasound, which showed no stones and nothing abnormal, had an abdomen and pelvis cat scan with no abnormalities, then done a gallbladder ultrasound which am waiting for the results.  Have an appointment with a urologist but the doctor couldnt find any appointments sooner than April 16th.  The pain in my rt kidney is on my last nerve.  There is no burning anymore when I urinate there is just the constant severe pain in my rt lower back where the kidney is located which is somewhat tender if enough pressure is applied.  My pain is worse at night to where I can barely turn over without taking my breath away.  I am still on the microbid twice daily and guess I will be until I see the urologist.  I have not missed any antibiotics and am not taking any other meds.
I have been on antibiotics consistently since Oct.  The dr ordered lorcet for the pain which I think makes the pain worse afterwards with little relief during the dose so I take only advil if I think it will help but gives very little relief.  Please give me your advise I am worried that the longer I wait the more damage is being done.  Thanks  Sherri
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Avatar universal

What type of casts and crystals were found?

Casts of red blood cells may suggest glomerulonephritis, while white blood cell casts may suggest a kidney infection or pyelonephriris. Crystals may occur normally such as calcium oxalate crystals , however, cystine crystals are rare and may be due to an underying metabolic problem.

Other factors need to be considered also such as the amount of protein in the urine. Was a 24 hour urine collection done, a urine cultur done ?Was a CBC done? Serum cholesterol, serum calcium levels , BUN ,Creatinine if indicated?

Your scans did not show any stones that could cause an obsruction,. However, diagnoses for pyelonephritis is usually clinical.

Keep in touch with your current physicians for any headaches, fever or vomiting. Continue your medications and inform them of your progress. Drink plenty of fluids, eat well and take lots of rest. If the pain becomes severe and associated symptoms like fever and vomiting appear do not hesitate to seek consult at the ER.

Other differentials like glomerulonephritis may present with hypertension, change in the character of the urine, swelling of the extremities.

Do keep us posted regarding your physician's advice.

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