Is pyelonephritis easy to treat?

Written by Zhou Qi
Nephrology
Updated on January 25, 2025
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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
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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Symptoms of recurring pyelonephritis

Pyelonephritis is an upper urinary tract infection. When the condition recurs, the initial symptoms are similar. Patients may also experience fever, and the temperature can rise quickly, even up to 40 degrees Celsius. There may also be a systemic inflammatory response, characterized by fatigue and loss of appetite, among other symptoms. Recurrence can also cause pain in the lumbar region, which may even radiate to the perineal area, and patients may also experience visible hematuria. In urinalysis, leukocytes or positive leukocyte esterase can be observed. These are the symptoms of recurring pyelonephritis.

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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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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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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.)