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Urinary Tract Infections

This information is for people with autosomal dominant polycystic kidney disease (ADPKD), their families and friends. 

People with ADPKD can get urinary tract infections (UTIs). These infections might involve the bladder, the tubes to and from the bladder, or the kidneys. Here we explain the causes and symptoms of these infections, as well as how they are diagnosed and treated.

Contents

Where can UTIs occur?

One of the more common places in the body to get an infection (whether or not you have ADPKD) is your urinary tract. 1 These are known as urinary tract infections (UTIs) and can occur in one or more of these places:

  • a kidney — an infection here is called pyelonephritis
  • the bladder — an infection here is called cystitis
  • the tubes (ureters) carrying urine from the kidneys to the bladder — an infection here is called ureteritis
  • the tube you pee through (the urethra) — an infection here is called urethritis

In people with ADPKD, infections can also occur within cysts in the kidneys. 2 Although these are infections within the urinary tract, they are usually thought of separately to other UTIs. We have a separate web page on cyst infections.

On this web page, we focus on infections of the bladder, connecting tubes, and general kidney infections.

Figure 1. The different parts of the urinary system.
By BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

A diagram showing the urinary system, which sits in the bottom half of the abdomen. Two kidneys sit above the bladder. Each kidney is connected to the bladder by a tube called a ureter. A tube at the bottom of the bladder, called the urethra, carries urine to the outside of the body.

What are the symptoms of a UTI?

Symptoms of a UTI can include: 3

  • pain or burning when you pee
  • needing to pee more often and suddenly
  • pee looking cloudy or smelling different
  • blood in your pee (which could make it look pinker or browner than usual)
  • pain in your abdomen (tummy) or lower back
  • feeling hot or shivery
  • a high temperature (above 38°C)
  • a low temperature (under 36°C)
  • feeling confused or delirious

Some of these symptoms can be caused by other complications of ADPKD, such as an infected cyst, kidney stone, or bleeding cyst. 4 Your kidney specialist (nephrologist) will use tests to find the cause of your symptoms.

How common are UTIs in people with ADPKD?

UTIs are common among people with ADPKD. About 3—5 in every 10 people with ADPKD get at least one UTI in their lifetime. 5

You’re more likely to get UTIs as you get older. 2,6 You’re also more likely to get a UTI if you: 3,7,8

  • are a woman
  • have sex
  • need a catheter to collect urine or another procedure in your urinary tract
  • have low kidney function
  • have very large kidneys
  • take immunosuppressants (for example, because you have had a kidney transplant)

Sometimes, UTIs come back (recur) after treatment. 9 Having a recent UTI makes it more likely you’ll get another one.

What causes UTIs?

Most UTIs in people with ADPKD are caused by bacteria that usually live in the gut, such as E. coli. 1,7,9,10 The bacteria enter the urinary tract through the urethra (where you pee from) and can travel up to the bladder and kidneys. 1 Women are more likely to get UTIs because they have a shorter urethra than men. 1

Bacteria can also enter your urinary tract when medical instruments are put into it, such as: 9

  • a catheter, which is a tube to collect urine
  • a cystoscope, which is a long, thin camera to look inside the bladder

How is a UTI diagnosed?

Your doctor (GP) will ask about your symptoms and may ask for a urine sample to test for signs of infection and micro-organisms. 9 This is usually enough to diagnose a bladder infection. If you have signs of a kidney infection, you might be offered an ultrasound scan or other scan to check the kidneys. 9

How is a UTI treated?

Antibiotics

Infections should be treated promptly before they get worse. 7 Bacterial infections are treated with antibiotics. It’s important that the right antibiotic is used for the right length of time. 9

Your doctor will start you on a course of antibiotics that are likely to work right away. While you start taking them, your urine sample will be tested to check which type of bacteria is causing your infection. Once the results are in, your doctor will change your prescription if needed, so that you get antibiotics that work well against the bacteria found. 9

Bladder infections are usually treated with a 3—5 day course of antibiotics. 9 Kidney infections can need 1—2 weeks of antibiotics, or longer in some cases. 5,9

Sometimes, the first course of antibiotics does not work well or the infection returns. 1,9 If this happens, your doctor will prescribe a different antibiotic for you to try or will give you a longer course of antibiotics. 1

Drinking enough water

If you have a UTI, make sure you drink plenty of fluid, so you stay hydrated, 1 unless your doctor recommends otherwise. Limit drinks containing caffeine, such as coffee, tea, and cola.

If you’re hydrated, your pee should be clear to light yellow. 1

A diagram showing the colour that pee will be if you’re hydrated versus dehyrated. Urine is clear to light yellow if you’re hydrated — drink as you get thirsty. Urine is dark yellow to amber if you’re dehydrated — have a drink of water.

Pain medication

UTIs can be painful. 1 Paracetamol can often help. 1 If this isn’t easing your pain, ask your doctor or pharmacist which other painkillers are suitable for you. If your kidney function is low or you’ve had a transplant, talk to your doctor before using nonsteroidal anti-inflammatory drugs, for example ibuprofen or Nurofen®. 11

Can you reduce the risk of getting a UTI?

General steps

To reduce your chance of getting a UTI: 1

  • Drink enough fluid to stay hydrated.
  • Don’t delay peeing when you need to go.
  • Pee after having sex.
  • Keep your genitals clean and dry.
  • Avoid tight or nonbreathable underwear.
  • Promptly change incontinence pads when soiled.

      Women should wash with water after sex and should wipe from front to back after going to the toilet.

      Cranberry

      Some people say that drinking cranberry juice or taking cranberry tablets or capsules can reduce the chance of getting a UTI. However, clinical studies have had mixed results. 1,9 Overall, there’s no proof that cranberry products work, but they’re unlikely to do you harm. 9

      Probiotics

      For women, vaginal probiotics containing Lactobacilli (‘friendly bacteria’) are claimed to reduce the risk of UTIs. These are designed to increase numbers of friendly bacteria in the vagina. They come in different forms, such as tablets to swallow or a gel or tablet to put into your vagina. 12,13

      Clinical studies of these products have had mixed results — they sometimes worked and sometimes did not. 9,13 It’s possible that some Lactobacillus species work better than others. 1,9

      Lactobacillus species that might have some benefit (but are still unproven) include: 

      • Lactobacillus rhamnosus GR-1
      • Lactobacillus reuteri B-54 or RC-14
      • Lactobacillus casei Shirota
      • Lactobacillus crispatus CTV-05

      If you would like recommendations for probiotic products, ask your pharmacist.

        Antibiotics for prevention

        If you get UTIs frequently and other measures are not helping, your doctor might recommend you take antibiotics regularly long-term. 14 They will want to chat with you after 6 months to review this plan. 14

        Women who have been through the menopause might be offered vaginal oestrogen (a product containing oestrogen put into the vagina). 14 This might help to reduce the risk of UTIs. 14

        Your doctor will explain the risks and benefits of any medicines to prevent UTIs. 14

          More from the PKD Charity

          Managing ADPKD pain
          Blood in the urine
          Kidney stones

          Information and support from others

          The Bladder and Bowel Foundation has helpful, general information on UTIs.

          References

          1. Flores-Mireles AL, Walker JN, Caparon M, et al. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology. 2015;13:269–284.
          2. Jouret F, Lhommel R, Devuyst O, et al. Diagnosis of cyst infection in patients with autosomal dominant polycystic kidney disease: attributes and limitations of the current modalities. Nephrology Dialysis Transplantation 2012;27:3746–3751.
          3. NHS. Urinary tract infections (UTI). Updated 22 March 2022.
          4. Ars E, Bernis C, Fraga G, et al. Spanish guidelines for the management of autosomal dominant polycystic kidney disease*. Nephrology Dialysis Transplantation 2014;29:iv95-iv105.
          5. Chebib FT, Torres VE. Autosomal dominant polycystic kidney disease: core curriculum 2016. American Journal of Kidney Disease. 2016;67:792–810.
          6. European Association of Urology. Guidelines on urological infections. 2023.
          7. Guler S, Cimen S, Hurton S, et al. Diagnosis and treatment modalities of symptomatic polycystic kidney disease. In: polycystic kidney disease, 2015. Ed: Li X. Codon Publications. Brisbane, Australia.
          8. Eroglu E, Kocyigit, Cetin M, et al. Multiple urinary tract infections are associated with genotype and phenotype in adult polycystic kidney disease. Clinical Experimental Nephrology. 2019;23(10):1188-1195.
          9. Bonkat G, Bartoletti R, Bruyère F, et al. European Association of Urology (EAU) Guidelines on Urological Infections. 2023.
          10. Harris PC, Torres VE. Polycystic kidney disease, autosomal dominant. GeneReviews® [Internet]. Last Updated 19 July 2018.
          11. National Kidney Federation. Over the counter drugs. Updated July 2023.
          12. Canales J, Rada G. Are probiotics effective in preventing urinary tract infection?. Medwave. 2018;18(2): e7185.
          13. Gupta V, Mastromarino P, Garg R. Effectiveness of prophylactic oral and/or vaginal probiotic supplementation in the prevention of recurrent urinary tract infections: A randomized, double-blind, placebo-controlled trial. Clinical Infectious Diseases. 2024;78(5):1154-1161.
          14. NICE. Urinary tract infection (recurrent): antimicrobial prescribing (NG112). 31 October 2018 (due for update November 2024).

          Authors and contributors

          Written by Hannah Bridges, PhD, medical writer, HB Health Comms Ltd. Expert review by Dr Matt Gittus, Specialist Nephrology Registrar, Sheffield Teaching Hospitals NHS Foundation Trust.

          With thanks to all those affected by PKD who contributed to this publication.

          © November 2024 (v3.0). Due for medical review November 2027.

          IS Ref No: ADPKD.UTI.V3.0

          Disclaimer: This information is primarily for people in the UK. We have made every effort to ensure that the information we provide is correct and up to date. However, it is not a substitute for professional medical advice or a medical examination. We do not promote or recommend any treatment. We do not accept liability for any errors or omissions. Medical information, the law and government regulations change rapidly, so always consult your GP, pharmacist or other medical professional if you have any concerns or before starting any new treatment.

          We welcome feedback on all our health information. If you would like to give feedback about this information, please email .

          If you don't have access to a printer and would like a printed version of this information sheet, or any other PKD Charity information, call the PKD Charity Helpline on 0300 111 1234 (weekdays, 9am-5pm) or email .

          The PKD Charity Helpline offers confidential support and information to anyone affected by PKD, including family, friends, carers, newly diagnosed or those who have lived with the condition for many years.