How is pyelonephritis treated?

Written by Li Liu Sheng
Nephrology
Updated on December 20, 2024
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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 Li Liu Sheng
Nephrology
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What causes acute pyelonephritis?

Acute pyelonephritis refers to an acute inflammatory disease caused by bacteria invading the renal pelvis. It is commonly seen in women of childbearing age, the elderly, individuals with weakened immune systems, and patients with urinary tract obstructions. The main clinical manifestations of acute pyelonephritis typically include frequent urination, increased urination frequency, painful urination, back pain, fever, cold stomach, and it can even present symptoms such as headache, whole body muscle soreness, nausea, and vomiting. The most common pathogen causing acute pyelonephritis is Escherichia coli, while other bacteria such as Klebsiella pneumoniae, Proteus, and Pseudomonas aeruginosa can also cause infections of acute pyelonephritis. Therefore, it is crucial to actively choose sensitive antibiotics for the treatment of acute pyelonephritis.

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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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Pyelonephritis is an infection of the kidneys

In fact, pyelonephritis is not really nephritis; it is actually a type of bacterial inflammatory infection. Bacteria can infect many parts of the body. If the urinary system is infected and it reaches the renal pelvis and calyces, it is referred to as pyelonephritis. Over 95% of pyelonephritis cases are caused by bacterial infections, and 70% are due to Escherichia coli. Generally, this bacteria enters the urinary system from the urethral opening and ascends to the renal pelvis and calyces, where it proliferates and causes an inflammatory response. The main clinical symptoms of the patient are fever and back pain, and the patient may also experience gross hematuria (visible blood in urine).

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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.

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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.