How do you get pyelonephritis?

Written by Li Liu Sheng
Nephrology
Updated on January 01, 2025
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Pyelonephritis is a clinical type of urinary tract infection, which refers to the inflammatory disease caused by the growth and reproduction of various pathogens in the renal pelvis. Pyelonephritis is usually divided into acute pyelonephritis and chronic pyelonephritis. Acute pyelonephritis is primarily characterized by frequent urination, urgency, painful urination, chills, fever, back pain, overall muscle soreness, and tenderness or percussion pain in one or both kidney areas. Chronic pyelonephritis, on the other hand, shows varying degrees of bilateral renal damage, reduced kidney size, rough surfaces, renal papillary scars, renal tubular atrophy, and chronic inflammation signs such as lymphocyte infiltration in the renal interstitium. Chronic pyelonephritis typically presents with low-grade fever, weight loss, backache, and anemia. Therefore, sufficient attention should be given to pyelonephritis, as chronic pyelonephritis can lead to uremia in patients.

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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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What foods to eat for pyelonephritis

Pyelonephritis is not nephritis, but a type of bacterial infection. Therefore, as a bacterial infection, there are no specific dietary restrictions for patients. Such patients should ensure adequate intake of fluids, with a recommended daily urine output of over 2000ml. This can help flush the urinary system and wash away some bacteria, reducing bacterial proliferation. Since it involves inflammation, it is advisable to follow a lighter diet, avoiding spicy, stimulating, and greasy foods, and focusing on easily digestible and warm foods.

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The difference between pyelonephritis and nephritis

Pyelonephritis and nephritis are two completely different concepts. Pyelonephritis is actually a bacterial inflammation, usually caused by bacteria at the urethral opening ascending into the urinary system and causing inflammation in areas like the renal pelvis and calyces. Patients may experience symptoms such as fever, hematuria, and back pain. In severe cases, it can cause necrosis of the renal papillae, leading to acute renal failure. Some patients may also develop perinephric abscesses, which are caused by bacterial infections. Nephritis, on the other hand, refers to inflammation within the glomeruli. This type of inflammation does not involve bacteria and is related to disorders in the body’s immune function. The disordered immune response is aggressive, attacking the glomerular filtration barrier, leading to proteinuria and hematuria. Therefore, the mechanisms of disease and treatment methods for the two conditions are different.

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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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What causes acute pyelonephritis?

Acute pyelonephritis, also known as an upper urinary tract infection, occurs when certain pathogens enter the urinary system and cause inflammation in areas such as the renal pelvis and calyces. Patients typically exhibit symptoms such as fever, back pain, and may also experience visible blood in the urine. The condition often has a severe onset. The common pathogens causing this type of infection primarily include bacteria, fungi, and viruses, among which the vast majority of cases are caused by bacterial infections. Furthermore, Gram-negative bacilli constitute the majority of these bacteria, with Escherichia coli being the most common.