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Welcome to the boards, and I am sorry you are having considerable issues, but glad you are trying to get it checked out. First, a urologist is appropriate to treat any obstruction in the ureter causing hydronephrosis, but a nephrologist is the Dr you want to address the actual kidney function. You need lots of tests, and perhaps have had some of these done. An ordinary urinalysis is important to check for blood, protein and casts in urine. A creatinine level is important, as well as BUN. The hydronephrosis may be causing the decrease in kidney function and may be reversible. On the other hand, lupus can cause direct damage to the kidneys and needs to be assessed by a nephrologist. A negative anti dsDNA does NOT rule out lupus. Have you had an ANA done? Only 30% of lupus patients have anti dsDNA and that usually shows up in people with lupus kidney involvement. So it is a good test, but tells you nothing if negative. You should see a rheum for a full workup, with all symptoms and labs previously done reported. Your symptoms are certainly suggestive, and it can be treated to help you feel better and prevent damage to organs and kidneys, etc. Please don't delay in getting this evaluation underway.

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