The difference between pyelonephritis and nephritis

Written by Zhou Qi
Nephrology
Updated on September 09, 2024
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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
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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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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.

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What foods to eat for pyelonephritis

Pyelonephritis is not nephritis, but a type of bacterial infection. Therefore, as a bacterial infection, there are no specific dietary restrictions for patients. Such patients should ensure adequate intake of fluids, with a recommended daily urine output of over 2000ml. This can help flush the urinary system and wash away some bacteria, reducing bacterial proliferation. Since it involves inflammation, it is advisable to follow a lighter diet, avoiding spicy, stimulating, and greasy foods, and focusing on easily digestible and warm foods.

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Is pyelonephritis easy to treat?

Pyelonephritis is generally not difficult to treat. Because the condition often appears quite aggressive, it is caused by bacteria entering the urinary system through the urethra, leading to an inflammatory response. Therefore, the primary treatment involves using antibiotics to kill the bacteria. Most of the bacteria causing pyelonephritis are Gram-negative rods, so antibiotics sensitive to Gram-negative rods are often chosen. After a treatment course of 10-14 days, the patient's condition is generally controllable and curable. However, there are also a few cases of chronic pyelonephritis, involving complex factors related to urinary tract infections, such as urinary tract malformations, urinary system stones, prostate hyperplasia, diabetes, etc., which make treatment more difficult. (Medication should be used under the guidance of a doctor.)

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Written by Zhou Qi
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How to check for pyelonephritis?

Pyelonephritis, also known as upper urinary tract infection, is mostly caused by bacterial infection and the inflammatory response of the urinary system. The screening for this disease involves routine urine tests. Presence of white blood cells in the urine, coupled with symptoms like fever and back pain, can lead to a preliminary diagnosis. However, to confirm the diagnosis and identify the specific infecting pathogen, a culture of midstream urine is needed. Generally, to exclude certain causes of pyelonephritis, it is also necessary for the patient to have blood sugar levels checked and an ultrasound of the urinary system conducted. These tests can confirm whether the patient has diabetes, urinary system stones, or obstructions in the urinary system. Male patients can also undergo a prostate ultrasound to rule out urinary obstruction caused by prostate enlargement. These examinations can also help determine why the patient might have developed pyelonephritis.