Pyelonephritis is an infection of the kidneys

Written by Zhou Qi

Nephrology

Updated on September 18, 2024

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In fact, pyelonephritis is not really nephritis; it is actually a type of bacterial inflammatory infection. Bacteria can infect many parts of the body. If the urinary system is infected and it reaches the renal pelvis and calyces, it is referred to as pyelonephritis. Over 95% of pyelonephritis cases are caused by bacterial infections, and 70% are due to Escherichia coli. Generally, this bacteria enters the urinary system from the urethral opening and ascends to the renal pelvis and calyces, where it proliferates and causes an inflammatory response. The main clinical symptoms of the patient are fever and back pain, and the patient may also experience gross hematuria (visible blood in urine).

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Written by Zhou Qi

Nephrology

1min 3sec

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How is acute pyelonephritis treated?

Acute pyelonephritis is a problem caused by an infection, also known as an upper urinary tract infection. Therefore, the treatment plan for this disease should be based on the pathogen. The vast majority of acute pyelonephritis is caused by bacterial inflammation, so antibiotics are often required. It is generally recommended that patients should receive intravenous antibiotic treatment to kill the bacteria, choosing the antibiotics sensitive to the results of urine culture. After 10 to 14 days of treatment, the condition of acute pyelonephritis can usually be controlled in most cases. The patient's body temperature will gradually decrease, symptoms of back pain will ease, and the white blood cells in the urine will also disappear. Only a very few cases of acute pyelonephritis are difficult to treat because such patients may have predisposing factors to urinary tract infection such as diabetes and urinary system stones. (Specific medication use should be conducted under the guidance of a doctor.)

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Written by Li Liu Sheng

Nephrology

57sec

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What causes acute pyelonephritis?

Acute pyelonephritis refers to an acute inflammatory disease caused by bacteria invading the renal pelvis. It is commonly seen in women of childbearing age, the elderly, individuals with weakened immune systems, and patients with urinary tract obstructions. The main clinical manifestations of acute pyelonephritis typically include frequent urination, increased urination frequency, painful urination, back pain, fever, cold stomach, and it can even present symptoms such as headache, whole body muscle soreness, nausea, and vomiting. The most common pathogen causing acute pyelonephritis is Escherichia coli, while other bacteria such as Klebsiella pneumoniae, Proteus, and Pseudomonas aeruginosa can also cause infections of acute pyelonephritis. Therefore, it is crucial to actively choose sensitive antibiotics for the treatment of acute pyelonephritis.

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Written by Zhou Qi

Nephrology

58sec

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Principles of treatment for pyelonephritis

Pyelonephritis, also known as an upper urinary tract infection, is a bacterial inflammation, with over 95% being caused by bacterial infections, among which 70% are caused by Escherichia coli. Therefore, as a bacterial infection-induced inflammation, antibiotic treatment is of course necessary. Clinically, third-generation cephalosporins or fluoroquinolone antibiotics are often chosen for bactericidal treatment. For acute pyelonephritis, it is generally recommended that medication be administered for 14 days, alongside measures such as increased water intake and frequent urination. In cases of chronic pyelonephritis, a low-dose, long-course antibacterial treatment, such as using nitrofurantoin, may also be employed, with continuous medication for two months. (Please consult a clinical doctor for specific medication use; do not self-medicate.)

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Written by Zhou Qi

Nephrology

1min 4sec

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The difference between pyelonephritis and nephritis

Pyelonephritis and nephritis are two completely different concepts. Pyelonephritis is actually a bacterial inflammation, usually caused by bacteria at the urethral opening ascending into the urinary system and causing inflammation in areas like the renal pelvis and calyces. Patients may experience symptoms such as fever, hematuria, and back pain. In severe cases, it can cause necrosis of the renal papillae, leading to acute renal failure. Some patients may also develop perinephric abscesses, which are caused by bacterial infections. Nephritis, on the other hand, refers to inflammation within the glomeruli. This type of inflammation does not involve bacteria and is related to disorders in the body’s immune function. The disordered immune response is aggressive, attacking the glomerular filtration barrier, leading to proteinuria and hematuria. Therefore, the mechanisms of disease and treatment methods for the two conditions are different.

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Written by Zhou Qi

Nephrology

1min 10sec

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How is pyelonephritis caused?

Pyelonephritis can also be referred to as an upper urinary tract infection. It occurs when bacteria proliferate in parts of the kidney such as the renal pelvis and calyces, leading to inflammation. In most cases, these bacteria enter the urinary system retrogradely from the urethral opening and cause inflammation in areas like the renal pelvis and calyces. Normally, bacteria are already present at the urethral opening, and when the body's immune system is functioning well and the urinary system is unobstructed, it is difficult for these bacteria to enter the urinary system and cause an inflammatory response. However, in patients with weakened immune systems, such as those suffering from a cold, diabetes, or those using steroid medications, bacteria may enter the urinary system and replicate in large numbers. Additionally, if there are obstructive factors in the urinary system, such as prostate enlargement in male patients, or if the patient has urinary system stones or tumors, bacteria are more likely to cause an inflammatory response.