Urinary Issues: Causes and Kidney Health Concerns

Q: Urinary Issues: Causes and Kidney Health Concerns

Hello： <br>1. <br>Could a decrease in urine flow and slow urination be due to insufficient water intake or excessive sweating? Or could it be caused by a blockage, etc.? -- If there are no injuries or infections, the likelihood is low.<br>2. <br>Could slow and reduced urine flow

Urinary problems

Hello Doctor, I previously inquired about frequently needing to use the restroom, but it has improved.
However, I have noticed that in the past few days, my urine flow has decreased and become slower (the volume of urine has also decreased), and it seems like I drip a few drops after urinating (the urine upon waking is also less).
Additionally, my back occasionally experiences sudden pain.
I would like to ask the doctor:
1.
Could the decreased and slow urine flow be due to insufficient water intake or excessive sweating, or could it be due to a blockage, etc.?
2.
Could the slow and reduced urine flow upon waking be caused by holding urine for too long?
3.
Could all of the above lead to kidney problems, or could kidney issues be the cause of these symptoms? In February, my blood test showed a glomerular filtration rate of 91.7, and over the past three years, my results have gradually decreased from 112 to 102 to 94 every six months.
Does this indicate that my kidneys are starting to deteriorate, and will I need dialysis in a few years? (I have noticed that my creatinine levels have increased, but they are still within the normal range.) Should I reduce my egg intake? Thank you, Doctor.

Wei, 20~29 year old female. Ask Date: 2021/07/03

Dr. Du Shixi reply Urology

Hello:
1.
Could a decrease in urine flow and slow urination be due to insufficient water intake or excessive sweating? Or could it be caused by a blockage, etc.? -- If there are no injuries or infections, the likelihood is low.
2.
Could slow and reduced urine flow upon waking be due to holding urine for too long? -- The likelihood is low.
3.
Could the above issues lead to kidney problems, or are kidney problems causing these symptoms? -- Multiple tests are needed for a comprehensive assessment.
In February, my blood test showed a glomerular filtration rate (GFR) of 91.7.
Over the past three years, my GFR has gradually decreased from 112 to 102 to 94 every six months.
Does this indicate that my kidneys are starting to deteriorate, and will I need dialysis in a few years? (I have noticed that my creatinine levels have increased, but they are still within the normal range.) Should I reduce my protein intake? -- This should be explained by the physician who ordered your blood tests.
Kidney function assessment requires multiple tests for accurate judgment.
The decreasing numbers indicate a trend, so it is important to pay attention to your lifestyle, such as drinking plenty of water, limiting sugary beverages, and maintaining a healthy diet low in salt, etc.
Wishing you good health.

Reply Date: 2021/07/03

More Info

Understanding urinary issues can be complex, especially when symptoms persist over time. Based on your description, several factors may contribute to your urinary symptoms, including decreased urine flow, slow stream, and occasional back pain. Let's break down your concerns and explore potential causes and implications for kidney health.

1. Decreased Urine Flow and Slow Stream: A reduction in urine flow can indeed be influenced by hydration levels. If you are not drinking enough water or losing fluids through sweating, this can lead to concentrated urine and a decreased volume. However, other factors could also be at play. For instance, urinary obstruction due to conditions such as benign prostatic hyperplasia (BPH) in men, or bladder dysfunction, can cause a slow stream and incomplete emptying of the bladder. If you are experiencing a sensation of dripping after urination, this could indicate that your bladder is not fully emptying, which can be a sign of obstruction or bladder muscle weakness.

2. Morning Urination: Waking up with a slow and reduced urine stream can be related to several factors. If you have been holding urine for an extended period, it may lead to bladder overdistension, which can affect the bladder's ability to contract effectively. Additionally, if you are experiencing any form of urinary retention, this could contribute to the sensation of incomplete emptying and a slow stream.

3. Kidney Health Concerns: Your concerns about kidney function are valid, especially given your history of decreasing glomerular filtration rate (GFR) over the past few years. A GFR of 91.7 is still within the normal range, but the trend of gradual decline is something to monitor closely. Elevated creatinine levels, even if within normal limits, can indicate that your kidneys are under some stress or that there may be early signs of kidney dysfunction. It is essential to maintain regular follow-ups with your healthcare provider to monitor these changes and assess kidney function over time.

4. Dietary Considerations: Regarding your question about dietary restrictions, particularly concerning protein intake, it is essential to balance your diet according to your kidney function. While protein is vital for health, excessive intake can put additional strain on the kidneys, especially if there is any underlying kidney disease. It would be prudent to consult with a dietitian or your healthcare provider to tailor a diet that meets your nutritional needs while considering your kidney health.

In summary, your urinary symptoms could stem from a combination of hydration status, potential urinary obstruction, and bladder function issues. It is crucial to address these symptoms with your healthcare provider, who may recommend further evaluations such as a urinalysis, ultrasound, or urodynamic studies to assess bladder function and rule out any obstructions. Regular monitoring of kidney function through blood tests will also help track any changes over time.
If you notice any worsening symptoms, such as increased back pain, changes in urination patterns, or any new symptoms, seek medical attention promptly. Early intervention can often prevent further complications and help maintain kidney health.

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