How is acute pyelonephritis treated?

Written by Zhou Qi
Nephrology
Updated on April 27, 2025
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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.)

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Written by Zhou Qi
Nephrology
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Can pyelonephritis be cured?

Whether pyelonephritis can be cured mainly depends on whether the patient has predisposing factors for urinary tract infections. These factors primarily include: Firstly, abnormalities in the anatomical structure of the urinary tract that may lead to obstruction of urine excretion, such as urological system stones, tumors, prolonged indwelling catheters, congenital abnormalities of the urinary system, and others. Additionally, there are some conditions that may lead to a decreased immune response, such as elderly individuals who are bedridden, those with diabetes, or patients using immunosuppressants. If the aforementioned factors are present, treatment of such cases of pyelonephritis might be challenging, with patients possibly experiencing recurrent episodes and potentially progressing to chronic pyelonephritis, eventually becoming difficult to cure completely. However, if none of these factors exist, the majority of cases with simple acute pyelonephritis can be cured and controlled by medication.

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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.)

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Written by Zhou Qi
Nephrology
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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.)

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Written by Zhou Qi
Nephrology
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How to diagnose pyelonephritis?

For the diagnosis of pyelonephritis, it is first necessary to confirm the diagnosis. Generally, patients should first undergo routine urine tests. In these tests, the presence of white blood cells and positive nitrites, along with clinical symptoms such as back pain, blood in urine, and fever are common. A routine blood test often shows elevated white blood cells and C-reactive protein. These indicators together suggest the presence of pyelonephritis. Furthermore, a culture of a clean-catch midstream urine sample can be done. If the bacteria grow to a certain quantity, it can also help in confirming the diagnosis of pyelonephritis. Additionally, to assess complications associated with pyelonephritis, it is necessary to perform blood tests for kidney function and an ultrasound of the urinary system to rule out conditions such as acute renal failure, renal papillary necrosis, and perinephric abscess, among others.

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Written by Pan Wu Shan
Nephrology
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What should not be eaten with pyelonephritis?

Pyelonephritis is actually a type of urinary tract infection, which can be divided into pyelonephritis and cystitis. If the bacteria are confined to the bladder without other symptoms, it is called cystitis. At this time, anti-infection treatment is needed, and recovery can usually be achieved within about three to seven days. However, if cystitis is not treated in time, causing the bacteria to enter the kidney along the urinary tract, the patient may develop systemic fever, sometimes high fever from 38°C to 39°C, and may also experience kidney percussion pain, back pain, etc. This condition is called acute pyelonephritis, and its anti-infection treatment course requires two weeks. If the treatment course is insufficient, it is very easy to relapse. Currently, for the diet of pyelonephritis, it is important to maintain a low-salt, low-fat, light diet, avoid spicy, stimulating, cold food, drink more water, and urinate frequently.