Principles of treatment for pyelonephritis

Written by Zhou Qi
Nephrology
Updated on September 08, 2024
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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
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Pyelonephritis is an infection of the kidneys

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
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What causes acute pyelonephritis?

Acute pyelonephritis, also known as an upper urinary tract infection, occurs when certain pathogens enter the urinary system and cause inflammation in areas such as the renal pelvis and calyces. Patients typically exhibit symptoms such as fever, back pain, and may also experience visible blood in the urine. The condition often has a severe onset. The common pathogens causing this type of infection primarily include bacteria, fungi, and viruses, among which the vast majority of cases are caused by bacterial infections. Furthermore, Gram-negative bacilli constitute the majority of these bacteria, with Escherichia coli being the most common.

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Written by Niu Yan Lin
Nephrology
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The difference between pyelonephritis and nephritis

Pyelonephritis and nephritis are two completely different diseases. Pyelonephritis is an infectious disease caused by bacteria, viruses, mycoplasma, chlamydia, etc. Treatment generally requires the use of antibiotics. The vast majority of patients can fully recover within two weeks under the treatment of sensitive antibiotics, without any sequelae. On the other hand, nephritis is mostly an autoimmune disease, not an infectious disease caused by pathogens. Therefore, its treatment does not require the use of antibiotics. Treatment usually involves ACE inhibitors or ARB type RUSH blockers, glucocorticoids, immunosuppressants, cytotoxic drugs, etc., and the course of nephritis is relatively long, with some patients having relatively poor prognosis. (Please use medication under the guidance of a doctor.)

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Written by Zhou Qi
Nephrology
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Acute Pyelonephritis Nursing Measures

Acute pyelonephritis, also known as an upper urinary tract infection, is a type of bacterial inflammation. In terms of care, patients should first focus on increasing their fluid intake. If the patient does not have urinary system stones, tumors, or other factors causing urinary obstruction—that is, if there is no kidney hydronephrosis—it is recommended that the patient's daily urine output be maintained at 2000-2500 milliliters. This means increasing fluid intake can help flush the urinary system, reducing bacterial growth and reproduction, which is beneficial for the treatment of pyelonephritis. Secondly, since the patient has acute inflammation, dietary considerations should include eating light, avoiding heavy and greasy foods as well as spicy and stimulating foods, and paying attention to perineal hygiene. Additionally, during episodes of fever, if the patient's body temperature is not very high, a warm water sponge bath can be given, especially focusing on the neck, armpits, and the root of the thighs, which can facilitate heat dissipation and is very beneficial for reducing body temperature.

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Written by Zhou Qi
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How do you get pyelonephritis?

Pyelonephritis, also known as upper urinary tract infection, is an inflammatory response caused by pathogens; 95% of pyelonephritis is caused by bacterial infections. Most cases involve bacteria from the urethral opening ascending into the urinary system to reach the kidneys, where they proliferate and cause inflammatory symptoms. Normally, there are bacteria present at the human urethral opening. Under normal immune function or absence of factors like significant urinary obstruction, it is unlikely for an upward bacterial infection to occur. However, under certain conditions, this type of infection may happen, prompting an inflammatory response from the pathogens.