The study aimed to characterize antibiotic prescribing patterns for urinary tract infections (UTIs) and to assess appropriateness, as well as factors associated with antibiotic treatment duration. A prospective descriptive study was conducted in 52 patients diagnosed with UTIs at the Department of Nephrology–Urology and Hemodialysis, Thai Nguyen National Hospital, from January 2025 to October 2025. Related factors were analyzed using the Chi-square test, calculating Odds Ratio (OR) with a 95% confidence interval; p<0.05 was considered statistically significant. The mean age was 59.79 ± 20.83 years; females accounted for 76.92% and 75% of patients had an eGFR <60 mL/min/1.73m². Escherichia coli represented 67.86% of isolates. Fifteen antibiotics were used, predominantly beta-lactams (± beta-lactamase inhibitors) and quinolones (63.41% and 24.39%, respectively), with monotherapy used in most cases (80.77%). The appropriateness rate of empiric antibiotic therapy was 51.92%, with remaining limitations in renal dose adjustment. A positive urine culture was statistically significantly associated with an antibiotic duration ≥7 days (OR = 0.142; 95% CI: 0.034–0.600, p = 0.004), which should be considered in antimicrobial stewardship efforts and in optimizing UTI management.