I had a kidney infection. How to manage vitamin D levels?

Question

Hello doctor,

A while back, I got some kind of kidney infection. I had a very smelly pee, pain that showed by the end of peeing, and that went away 30 seconds later (these symptoms stopped after some medication).

They could not figure out what it was, but my left ureter was swollen. It went down by itself, but I still get some phantom pain from it once in a while. It has been 10 months. And my pee is always bubbly. Why?

However, I had it tested, and it contains no protein. And, the pH levels are higher, and I have high calcium, only one point above the recommended level. Nevertheless, I have low vitamin D.

Your suggestions on this will be appreciated.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your CT (computed tomography) urogram, diuretic renogram (attachment removed to protect the patient's identity), and the information you have given.

Your scan showed mild left-sided hydroureteronephrosis, meaning the kidney and ureter were slightly dilated, but no stones or obstruction were seen, no mass or structural abnormality was detected, and the right kidney and urinary tract looked normal.

The renogram also confirms that there is no blockage in either kidney. This pattern can occur after a past infection or transient blockage (for example, a small stone or inflammation that later cleared).

The fact that it resolved spontaneously is reassuring. There is also a possibility that this may be a condition called vesicle-ureteral reflux (VUR), which generally tends to be present in someone since before they were born.

Although the fact that there is no history of you having repeated infections throughout your childhood until now makes the possibility of this being a VUR very minimal.

The bubbly urine you mention can come from:

Slight urinary alkalinity (you noted a higher pH).
Mild dehydration (concentrated urine traps air).

Since no protein was detected in your urine, it is not a sign of kidney damage. Your mildly elevated calcium and low vitamin D are likely linked. Low vitamin D causes the body to compensate by raising calcium absorption.

Both can be corrected with hydration, moderate dairy intake, and vitamin D supplementation under supervision. Persistent phantom discomfort is also likely due to the low vitamin D levels in your body.

My advice for you would be to:

Stay very well-hydrated and aim for clear or pale-yellow urine. This means consuming roughly three liters of fluids a day.
Avoid excessive caffeine, soda, or alcohol, as they can irritate the kidneys.
Repeat a renal panel and urine test every 6 months to ensure kidney function and calcium remain stable.
Supplement vitamin D (60000U once a week for 12 weeks).

Watch for warning signs: new flank pain, fever, visible blood in urine, or recurrent foul smell. In that case, seek review sooner.

If you continue to have intermittent left-flank pain, a renal ultrasound can check that the mild hydronephrosis has not returned. Usually, this isn’t progressive if the CT showed no cause.

Everything points toward a resolved episode of inflammation or minor obstruction rather than ongoing kidney disease.

Stay hydrated, correct your vitamin D deficiency, and re-check laboratory tests in a few months; that is all that is required.

Please follow up with me if you have any further questions.

Best wishes.