Trimethoprim and reduced Kidney funtion

[Danoco]

Hi Folks, hope your all having a great start the the new year.

Posted some months ago about having ecoli uti induced sepsis last May causing an AKI where GFR went down to 3. Since then its gone up slowly till a few months ago where it now seems to have plateau at eGFR 30/31.

Now i'm having my 2nd new uti (ecoli) infection in two months. First one they gave me Pivmecillinam anti-biotic in December and now yesterday with same recurring uti they have given me Trimethoprim, full dose 200mg twice a day for 7 days.

Reading patient info online it seems to say if GFR is 15-30, there should be a reduced amount after 3 days, but my GP has not indicated anything.

With my GFR 30/31 maybe the GP think i'm okay.

Just wondered if anyone here has expereince with Trimethoprim and recurring uti's which I read can occur with reduced Kidney function ?

I would ask my Nephrologist but he is almost impossible to get hold of (i live in a fairly remote area so not really an option to change Nephrologist)

One final question, last time i spoke to nephrologist in October he said if my kidney does not improve as hoped it can then be considered CKD rather an AKI. Does anyone agree with this ?

Thanks in advance

Dan

[nellie237]

Hi Danoco,

I've just finished a 5 day course of Trimethoprim 200mg X 2. I'm sorry to say that it did zero for my UTI, and my symptoms remained throughout. I'm now on a seven day course of Nitrofurantoin 100mg. It appears that it is common practice to try 1 antibiotic and if that fails, try another, in the hope that something eventually works........... basically shooting in the dark. You'd think they'd do better for CKD patients................

I had AKI in March last year, although not as severe. I can only imagine how concerned, and wanting answers you are.

One final question, last time i spoke to nephrologist in October he said if my kidney does not improve as hoped it can then be considered CKD rather an AKI. Does anyone agree with this ?

I'm not sure I agree with this at all. We all want to know the reasons for our kidney problems, and we want the medics who treat us to be aware of what caused the issue.

It comes from updated (2020) KDIGO guidelines:

"AKI to CKD Based on KDIGO's Research" (on YouTube)

Somebody recommended D-Mannose to me, and I have have been researching/asking for opinions

D-Mannose is thought to block E-coli bacteria from growing in the urinary system. It attaches to the E-coli bacteria and prevents it attaching to the cells in the urinary tract. The bacteria are removed on passing urine (voiding). (link in my post 3 days ago.. Glos Hospitals)

Some people think it works wonders, some that it didn't work at all...........so, a bit like the antibiotics. I have decided that I am going to get some to keep, in case all else fails.

Here's hoping that we both get rid of this asap.

[Danoco in reply to nellie237]

Thank you Nellie for the reply. Yes it does seem a bit hit and miss with antibiotics. Let's see if this one works for me though I have zero symptoms this time so difficult to tell. Guess I might need another urine and/or blood sample.Thanks for the YouTube link and other treatment options, I will have a look later

😁

[Bond-007]

Dan, See if you can get 2nd opinions remotely with Mobile telecommunications - these days you can have a physician 1000 miles away with telecommunications. Can’t hurt to try. Gives you one more opinion if you can’t get it locally.

[Danoco in reply to Bond-007]

Thanks, will give it a try if I have no joy with current consultant

[PecanSandie]

I gave D-Mannose to my dog when she had a urinary tract infection-It was recommended by my holistic vet.

I have had my share of UTIs and I find that cranberry juice helps.....doesn't cure, but relieves symptoms.

[Danoco in reply to PecanSandie]

Thanks Sandie

[Hidden]

Hi Danoco

I know this is a year later but I've experienced Trimethoprim subscribed for chronic UTI's, and it was not good! I now have moderate CKD.

One brief but horrible event with Trimethoprim involved angina and very severe fatigue (in addition to my permanent chronic fatigue) and who knows what other effects on heart/kidneys.

The only thing that saves me now from suffering permanent UTIs and consequential antibiotics is the specialised Interstitial Cystitis diet prescribed for me from a hospital specialist.

I wish it was given to me years ago before all the unnecessary pain/bleeding/drs visits/investigations/blood & urine tests/useless physio exercises/hospital Emergency Department visits/Cystoscopies, and stupid procedures like bladder distensions and years of permanent antibiotics that didn't do anything but cause issues elsewhere (eg kidneys?).

Can't find the exact copy of my prescribed IC diet online -even from the official hospital website.

But I have previously posted on healthunlocked.com/nkf-ckd/... where I managed to upload a few pages but not the entire copy of this diet.

Wishing you the best for your health.