Dr. Vivekanandan Govindasamy
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
High abdomen exercise resulted back and thigh stiffness and pain. For pain, I had heat application, but no medicines. It was bearable. I ate five to six mangoes at night. My urine and other things were normal. The next day, I had Diclofenac in the morning as muscles were more stiff at thigh and back. After two hours, I had a dark brown urine. Then, I took lots of water and urine color came down to normal pale yellow or white. I visited a urologist. He checked and said it seems to be fine, but since I have muscle pain to rule out 1 percent possibility of myoglobinuria. He suggests sonography, CBC, urine test, creatinine and plasma glucose. My sonography was normal and the blood test results are pending. I keep on drinking water and the urine is normal. Should I worry about my kidney? I am worried if my muscle stiffness may create problem in kidney. Please guide me.
Hi,
Welcome to icliniq.com.
Do not worry, nothing will happen to your kidneys. All you need to do is just check your creatinine and urine deposits. Even if there is myoglobinuria (muscle destruction result in the presence of myoglobin in urine), it usually settles with adequate hydration and avoidance of analgesics.
Patient's Query
Thank you doctor,
My urine test report shows leukocytes nil, RBCs 0-2, cast absent, creatinine 0.65 and BLGLUR 103.0. The CBC result showed Hb 13.2, RBC 4.75, PCV 40, MCV 84, MCH 27.9, MCHC 33, RDW 12,10, TC 12100, polymorphs 72, lymphocytes 24, eosinophils 1, monocytes 3, basophils 0, LC 2904, AEC 121, PC 203000, leukocytes negative, protein absent, ketone negative, urobilinogen 0.2, bilirubin negative and RBC trace. Do I need to retest till muscle pain subside?
Hi,
Welcome back to icliniq.com.
Since all the tests are within normal limits, you do not need to repeat anything. The tests clearly show that your kidneys are normal.
Patient's Query
Thank you doctor,
Though all results were normal, my doctor gave me Hydrochlorothiazide medicine for five days. My first brown urine (which could have traces of blood or myoglobulin, became normal after 1 hour. Can this temporary phenomena create any problem? Now, I am using the restroom for twice in an hour when I awake and once in three hours when I sleep. Do I need to take Hydrochlorothiazide? My muscle pain subsides by 90 percent today. Is that brown urine was the symptom of temporary myoglobinuria? Should I worry about this? Should I assume that my kidneys are clear as earlier and normal? My WBC and TC are on the higher side. Is that fine? I have mild thigh and back muscle pain. Can I use a heating pad and Diclofenac gel two to three times a day? I have attached my sonography and blood test reports.
Hi,
Welcome back to icliniq.com.
I clearly understand your concern and I want to reiterate the fact that your kidneys are perfectly safe, in spite of the single episode of brown urine. Do not worry about the total WBC count (white blood count) as they are nonspecific. I would advise you to stop taking Hydrochlorothiazide immediately, as they are not really indicated and have potential side effects. Kindly discuss this with your treating doctor. Yes, you can continue to use heat pad and topical Diclofenac gel. All you need to do is take plenty of fluids for a week or so and just relax. Repeat urine routine analysis after a couple of weeks and that is all that you need. All the best.
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Urology
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