I am 45, male. Why do I have frequent UTIs and high BP?

Question

Hello doctor,

I am a 45-year-old man dealing with chronic pain in my sides and back that has been getting progressively worse over the past few years. I have frequent urinary tract infections and sometimes notice blood in my urine, which is very concerning. My blood pressure has remained consistently high despite taking medication, and I often experience headaches and dizziness. Lately, I have been feeling more tired than usual and occasionally nauseous, and I can also feel large masses in my abdomen when pressing on my sides. Could these kidney-related symptoms, along with high blood pressure, be connected to an inherited condition affecting my kidneys?

Kindly advise.

Answer 1

Hello,

Welcome back to icliniq.com,

I understand your concern,

Your symptoms, chronic flank and back pain, recurrent urinary tract infections (UTIs), blood in the urine, high blood pressure resistant to medication, fatigue, nausea, and palpable abdominal masses, are concerning and could be linked to an underlying kidney disorder, possibly an inherited condition such as polycystic kidney disease (PKD).

It is an inherited condition where fluid-filled cysts develop in the kidneys, leading to:

Pain in the flanks or back due to enlarged kidneys.
High blood pressure (often difficult to control).
Blood in the urine (hematuria).
Recurrent UTIs or kidney infections.
Palpable abdominal masses (enlarged kidneys or liver cysts).
Over time, PKD can impair kidney function, causing fatigue and nausea as signs of declining kidney health.

The following conditions need to be ruled out:

Kidney stones can cause pain and blood in the urine.
Chronic kidney disease (CKD) from long-standing hypertension or other causes.
Kidney tumors are less common, but important to rule them out.

Before deciding on the next steps, the following investigations are advisable:

Imaging: Kidney ultrasound or computed tomography (CT) scan to check for cysts (PKD) or other structural changes.
Blood and urine tests: Kidney function tests (serum creatinine, estimated glomerular filtration rate (eGFR).
Urinalysis and urine culture (to detect infection, protein, or blood).
Blood pressure management: Since your hypertension is resistant, evaluation for kidney-related secondary causes is necessary.
Genetic counseling (if PKD is confirmed): As PKD is hereditary, family screening may be recommended.

Please follow up with a nephrologist (kidney specialist) as soon as possible.

Preventive measures include, if diagnosed early, strict blood pressure control, prevention of infections, and lifestyle modifications can help slow disease progression. If kidney function declines severely, dialysis or kidney transplantation may eventually be required, but early intervention can delay this outcome.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.