Your Kidneys and Bladder
Jan 22, 2014 1:48:06 GMT -8
Post by Butiki on Jan 22, 2014 1:48:06 GMT -8
Hi, I was looking around for information on Kidneys and SCI and came across this site. I found it very interesting, I hope you do too. I'm sorry its a bit old, 2009, but I don't think much has changed since then in this department. Being a Diabetic type 2, I am very aware of these things that otherwise might be overlooked.
Before 1940, most people with spinal cord injuries died from urinary tract infections in the first few months after injury. After the introduction of antibiotics in the 1940's, people started surviving longer, but renal complications continued to be a problem and kidney failure became the leading cause of death. With current management practices and periodic testing, things have improved greatly, and now fewer than 3% of people with SCI die from kidney failure.
The goal in choosing a method of bladder drainage is to find the simplest, most convenient and least expensive method that will keep you dry, avoid serious complications and treatment side effects, and preserve your kidneys for your entire life. There are several different methods, depending on your injury and circumstances, and almost all of them give good outcomes, with just a few exceptions.
When considering the use of antibiotics for UTIs, it is important to distinguish between actual infections and colonization.
If you have bacteria in the urine (found through a lab test) AND have symptoms (fever, pain, spasticity), then you have an infection that needs to be treated with antibiotics.
If you have bacteria in the urine but have NO symptoms, then you have what is called “colonization” and you should not be treated with antibiotics.
In general, treatment should be based on symptoms, rather than on bacterial count alone. Some bacteria don’t cause any symptoms, and their presence in the urine might even be keeping out other bacteria that could cause problems. In fact, there is currently some promising research into this idea of “bacterial interference” to determine whether inoculating people with a specific, relatively harmless bacteria will keep harmful bacteria away.
Prophylactic antibiotics, or taking antibiotics all the time to prevent UTIs, have not proven to be beneficial in research studies and can result in the proliferation of resistant bacteria that are hard to treat. A substance called methenamine, which turns into formaldehyde in the bladder, is used by some patients to try and reduce infections.
Cranberry (juice or tablets) has also been studied as a way of preventing UTIs. Usually the tablet form is used since drinking cranberry cocktail is so full of sugar and calories. Although cranberry has not proven effective in clinical trials with people who have SCI, it does seem to help some individuals. As with many aspects of bladder management after SCI, finding what works is often a matter of trial and error.
If you have bacteria in the urine (found through a lab test) AND have symptoms (fever, pain, spasticity), then you have an infection that needs to be treated with antibiotics.
If you have bacteria in the urine but have NO symptoms, then you have what is called “colonization” and you should not be treated with antibiotics.
In general, treatment should be based on symptoms, rather than on bacterial count alone. Some bacteria don’t cause any symptoms, and their presence in the urine might even be keeping out other bacteria that could cause problems. In fact, there is currently some promising research into this idea of “bacterial interference” to determine whether inoculating people with a specific, relatively harmless bacteria will keep harmful bacteria away.
Prophylactic antibiotics, or taking antibiotics all the time to prevent UTIs, have not proven to be beneficial in research studies and can result in the proliferation of resistant bacteria that are hard to treat. A substance called methenamine, which turns into formaldehyde in the bladder, is used by some patients to try and reduce infections.
Cranberry (juice or tablets) has also been studied as a way of preventing UTIs. Usually the tablet form is used since drinking cranberry cocktail is so full of sugar and calories. Although cranberry has not proven effective in clinical trials with people who have SCI, it does seem to help some individuals. As with many aspects of bladder management after SCI, finding what works is often a matter of trial and error.
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