How to check for pyelonephritis?

Written by Zhou Qi
Nephrology
Updated on September 22, 2024
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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.

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Written by Li Liu Sheng
Nephrology
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How is pyelonephritis treated?

Whether it is the treatment of acute pyelonephritis or chronic pyelonephritis, first of all, personal hygiene should be emphasized, physical fitness should be enhanced, water intake should be increased, and urination should be frequent. In addition, for patients with acute pyelonephritis, the main treatment is the use of sensitive antibiotics, which can be either semi-synthetic penicillin or cephalosporins, and fluoroquinolone antibiotics can also be used. For chronic pyelonephritis, if the patient has urinary anatomical or functional abnormalities, such as the presence of urinary stones or urinary obstruction, active surgical treatment can be considered to relieve the obstruction. Furthermore, patients with chronic pyelonephritis who also have hypertension and edema can appropriately use antihypertensive drugs and diuretics to control blood pressure and edema, which can play a role in protecting kidney function. (The use of medications should be conducted under the guidance of a doctor.)

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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What should I do if pyelonephritis recurs?

Pyelonephritis, also known as upper urinary tract infection, is an inflammatory reaction caused by bacterial infection of the urinary system. Therefore, in cases of recurrence of this condition, it is still necessary to use antibiotics for bactericidal treatment, generally requiring a full two-week course, choosing drugs with low nephrotoxicity. Additionally, it is important to investigate whether there are any complicating factors for pyelonephritis, such as the presence of diabetes, urinary system stones, tumors, or urinary tract anomalies. Identifying and addressing these complicating factors can reduce the likelihood of recurrence of pyelonephritis.

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Written by Zhou Qi
Nephrology
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Is pyelonephritis serious?

Pyelonephritis, also known as an upper urinary tract infection, occurs in the majority of cases when bacteria enter the renal pelvis and calices, causing an inflammatory response. This condition is indeed characterized by severe symptoms and an aggressive onset. Patients may suddenly develop a fever, with temperatures even exceeding 39°C, and experience back pain. Some patients may also exhibit clinical signs such as hematuria. The symptoms are indeed severe, and there is a pronounced systemic inflammatory response, leaving patients feeling listless, dizzy, headachy, and lacking appetite. However, the treatment for this disease generally yields good results. After antibiotic treatment, most patients can gradually see symptom relief within 3 to 5 days, and the condition is mostly curable after 10 to 14 days of medication.

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Written by Zhou Qi
Nephrology
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Is pyelonephritis more serious or nephritis more serious?

Pyelonephritis is an upper urinary tract infection caused by a bacterial infection, leading to an inflammatory response in the urinary system. The severity of this condition can vary. Nephritis, on the other hand, refers to the sterile inflammation within the glomeruli of the kidney, which also varies in severity. Therefore, it is challenging to compare these two diseases in terms of their severity. In the case of pyelonephritis, most conditions are relatively more treatable, and using antibiotics can control acute pyelonephritis. However, a small number of patients may develop severe complications such as perinephric abscess, acute renal failure, renal papillary necrosis, and even death from septic shock. The severity of nephritis also varies, with symptoms ranging from significant proteinuria to mild hematuria. Therefore, a comparison should be based on the specific conditions of the patients. (The use of medications should be under the guidance of a doctor.)