### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
my serum creatine is 3.8 , usg shows small kidney Rt. 7.8*3.7, Lt. 8.33*3.78 . my creatine hovering between 3 and 4 from last 3 months on june 30,2012 left renal colic began an urgent usg showed hydronphrosis hydroureter left creatine 4.3 on day 2 of hospitalisation surgen suggest for dj stent ,dj stent left side done on 2 july 2012 my past history i has recurrent uti with spiking fevers from 1 year , persistant heavy pyuria that was sterile on most occasions, the radiologic imaging did not show evidence of obstructive uropathy , i was empirically started on antitubercular drug because of prolonged history of fever with uti , recently completed anti tb theorpy that lasted 6 months, on 20 june 2012 creatine found to go up a dignosis of acute tubulo interstial nephritis caused by rifamipcin was made and anti tb theropy stopped, creatine continued to rise in spite of tb theropy being stopped in dec 2011 i was evaluated for pyuria and fever with chills and rigors in a private hospital in nagpur where usg revealed bening prostatic huperplasia with pvr of 10 ml serum psa was 26.71 and dignonosed to have prostatitis with bph with recurrent utis , i underwent diagnostic cystoscopy with holmium laser enucleation of prostate 25 gms, the histopathology revealed bph with mild prostitis in general examination bp 124/80 respiratory rate of 18/min,no pallar anicetric pls advice for further tretment and tests

### output:

Your kidneys seem to be significantly damaged from your description. Your doctor must have told you already that only some kidney function is left. There are few things you can get corrected and prolong your kidney function. Check your serum bicarbonate in a NASH accredited lab [most labs don't do this test properly]. The bicarbonate has to be between 22 and 24 me/l. Get serum vitamin D and serum PTH, serum calcium and serum phosphorus done appropriately treated. If your kidney function is rapidly worsening then get an AV-fistula done. If you need more clarification please contact. All the best. Hope it helps.