Creatinine is a late marker of kidney disease and often remains normal while damage is already underway. Low vitamin D contributes to early renal injury through hormonal imbalance, rising parathyroid hormone, RAAS activation, inflammation, and protein loss in the urine. These changes precede declines in GFR and explain why patients with “normal labs” may still be at significant risk for progressive kidney disease.

Vitamin D deficiency is not simply a consequence of kidney disease—it can actively accelerate renal injury. Proper vitamin D signaling suppresses harmful hormonal pathways, protects glomerular structures, and limits fibrosis. Concerns about kidney damage stem from rare cases of vitamin D toxicity, not physiologic replacement. When dosed appropriately and monitored, vitamin D supports kidney health rather than harming it.

Urinary tract infections (UTIs) are traditionally diagnosed using urinalysis followed by culture and sensitivity testing. While effective in most cases, these methods may miss fastidious or slow-growing organisms, fail to identify mixed infections, or return negative results despite continued patient symptoms. Urine polymerase chain reaction (PCR) testing provides a highly sensitive molecular alternative that detects microbial DNA directly, identifies antibiotic-resistance ge

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PCR is the standard of care in the diagnosis of urinary tract infections, particularly in the elderly and nursing home patients.

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