From the Guidelines
Urinary tract infections (UTIs) and kidney disease present with distinct signs and symptoms that can help identify these conditions, including local symptoms such as painful urination, frequent urination, and cloudy or strong-smelling urine, as well as systemic symptoms like fever, chills, and fatigue, particularly in pyelonephritis, as noted in recent guidelines 1.
Local and Systemic Signs and Symptoms
The signs and symptoms of UTIs and kidney disease can vary but often include:
- Local symptoms:
- Painful urination (dysuria)
- Frequent urination
- Urgency to urinate
- Cloudy or strong-smelling urine
- Blood in the urine (hematuria)
- Lower abdominal pain or pelvic pressure
- Systemic symptoms:
- Fever
- Chills
- Fatigue
- General malaise, particularly when the infection has spread to the kidneys (pyelonephritis)
Kidney Disease Symptoms
In kidney disease, symptoms often develop gradually and may include:
- Changes in urination patterns (increased or decreased frequency)
- Foamy urine indicating protein presence
- Persistent puffiness around the eyes
- Swelling in the hands, feet, or ankles due to fluid retention
- High blood pressure that's difficult to control
- Fatigue
- Shortness of breath
- Nausea
- Vomiting
- Metallic taste in the mouth
- Confusion or difficulty concentrating
Importance of Early Identification
Early kidney disease is often asymptomatic until significant function is lost, making regular screening important for those at risk, as emphasized in guidelines such as those from the European Association of Urology 1. Back pain near the kidneys can occur in both conditions but is typically more severe and accompanied by fever in pyelonephritis. These symptoms vary in severity depending on the extent of infection or kidney damage.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Local Signs and Symptoms of UTI or Kidney Disease
- Dysuria (painful urination) 2, 3
- Hematuria (blood in the urine) 2, 3
- Frequency (frequent urination) 2, 3
- Flank pain (pain in the side or back) 2, 3
- Nocturia (urination at night) 2, 3
Systemic Signs and Symptoms of UTI or Kidney Disease
- Fever 2, 4
- Chills 2, 4
- Nausea and vomiting 4
- Abdominal pain 4
- Sepsis (a life-threatening condition that occurs when the body's response to an infection damages its own tissues) 4
- Acute kidney injury (AKI) 4
Signs and Symptoms of UTI in Patients with Renal Impairment
- Increased risk of hospitalization for UTI, sepsis, and AKI 4
- Increased risk of death 4
- Older patients with renal impairment are at higher risk of adverse outcomes 4
Antibiotic Resistance and Treatment
- Rising rates of antibiotic resistance among UTI-causing bacteria 2, 5, 6
- Importance of choosing appropriate antibiotics based on patient's individual risk profile, prior antibiotic treatment, and antibiotic susceptibility 5
- Recommendations for first-line empirical treatment of uncomplicated UTI: fosfomycin-trometamol, nitrofurantoin, or pivmecillinam 5
- High-dose fluoroquinolones recommended as first-line oral treatment for uncomplicated pyelonephritis 5