How is pyelonephritis caused?

Written by Zhou Qi
Nephrology
Updated on September 26, 2024
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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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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.

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Written by Pan Wu Shan
Nephrology
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Can pyelonephritis lead to pregnancy?

Pyelonephritis is actually a urinary tract infection. It is not the same as nephritis, so do not confuse the two. Thus, pregnancy is completely feasible for someone with pyelonephritis; as long as the infection is treated, the urine test shows negative results, and there are no white blood cells, pregnancy can occur without any impact. Currently, the treatment for pyelonephritis is anti-infection therapy. Since the bacteria have entered the kidney via the urethra, this treatment needs to last for two weeks. If the treatment duration is insufficient, there could be a recurrence of pyelonephritis. Additionally, it is important to drink plenty of water, urinate frequently, avoid holding urine, consume more than 2500 milliliters of water daily, and maintain a light diet avoiding spicy and irritating foods.

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Written by Zhou Qi
Nephrology
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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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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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How many days does the high fever last in pyelonephritis?

Pyelonephritis, also known as an upper urinary tract infection, indeed tends to cause fever in patients. Generally, this type of fever can rise sharply in a short period of time, potentially exceeding 39°C. The duration of the fever mainly depends on the patient's own resistance and the effectiveness of the medication. If sensitive antibiotics are used and the patient has strong immune capabilities, the bacteria can be killed or mostly eliminated in a short period of time. In such cases, the patient's high fever may gradually subside within three to five days. However, if the medication is ineffective, the fever may persist for an extended period, possibly lasting up to half a month or even a month. (The use of medications should be carried out under the guidance of a professional doctor.)