10 acute pyelonephritis facts
In this article we will describe 10 acute pyelonephritis facts
1. Definition. Acute pyelonephritis is a severe bacterial infection of the kidney, primarily involving the renal pelvis and the interstitium (the tissue between the kidney tubules). It is usually of rapid onset.
2. Cause. The infection is usually caused by bacteria, most commonly Escherichia coli (‘E. coli’), which typically originates in the lower urinary tract and ascends to the kidneys.
3. Symptoms. Common symptoms include high fever, rigors, loin/back pain (pain on the sides of the lower back), painful urination, frequent urination, and cloudy or bloody urine.
4. Diagnosis. Diagnosis is usually made based on clinical symptoms, examination, and laboratory tests. Urinalysis (dipstick), mid-stream urine (MSU) culture, blood tests (including full blood count and inflammatory markers), are be used to confirm the diagnosis.
An ultrasound, US) are usually done – primarily to exclude other diagnoses, and to exclude obstruction causing pyelonephritis. It may show changes as shown below. But it is often normal. Milder cases treated at home with oral antibiotics do not need an US.
Diffuse acute pyelonephritis in a 31-year-old woman. (A) Longitudinal ultrasound of the left kidney shows diffuse enlargement with decreased echogenicity and loss of corticomedullary differentiation. (B) Normal right kidney.
5. Risk factors. Certain factors can increase the risk of developing acute pyelonephritis, including female gender (due to shorter urethra), urinary tract obstructions, urinary catheterisation, pregnancy, diabetes, and a weakened immune system.
6. Complications. If left untreated, acute pyelonephritis can lead to severe complications, such as kidney abscesses, sepsis (a systemic infection), and permanent kidney damage. It can also increase the risk of recurrent urinary tract infections.
7. Treatment. Treatment generally involves antibiotics to target the causative bacteria. In more severe cases, hospitalisation may be necessary for intravenous antibiotics and supportive care. Patients with milder cases can be treated at home with oral antibiotics.
8. Duration of treatment. The duration of antibiotic treatment varies but is usually around 10-14 days (longer than the 5-7 days for a ‘normal UTI’ (cystitis). It’s important to complete the full course of antibiotics even if symptoms improve.
9. Prevention. Preventive measures include maintaining good hygiene, drinking plenty of fluids, urinating regularly, and emptying the bladder completely. For individuals prone to recurrent infections, prophylactic antibiotics might be considered.
10. Chronic pyelonephritis. Chronic pyelonephritis is not a common outcome to acute pyelonephritis, even if the patient has recurrent attacks. It is usually secondary to reflux nephropathy that does not underlie the vast majority of attacks of acute pyelonephritis.
But, in a few patients, if acute pyelonephritis becomes a recurring or persistent issue, it can progress to chronic pyelonephritis, which leads to long-term kidney inflammation and scarring. This can lead to reduced kidney function, and CKD, over time.
Summary
We have described 10 acute pyelonephritis facts. We hope it has been helpful.
https://www.youtube.com/watch?v=VXFRWFHx6tA&list=PL2Bhof3MVebzT8PhBXBHhZ5F9XKjRAt3J&index=4
Last Reviewed on 15 October 2023