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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Written by Pan Wu Shan
Nephrology
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Does pyelonephritis cause a fever?

Pyelonephritis is actually a part of urinary tract infections, which are divided into cystitis and acute pyelonephritis. The main symptoms of cystitis are frequent urination, urgency, and painful urination, among other urinary irritative symptoms, and these do not involve fever. However, if cystitis is not treated in time, it can worsen into acute pyelonephritis, which then presents with symptoms such as fever and back pain. The fever with acute pyelonephritis can be quite high, often exceeding 38 or 39 degrees Celsius, and might last for two to three days. At this point, treatment requires anti-infective medications, which should be continued for two weeks without any interruption. If the treatment duration is insufficient, pyelonephritis may recur. It is important to drink plenty of water, urinate frequently, and avoid holding in urine. Drinking lots of water can help flush out bacteria from the urine early on, promoting a quicker recovery from the illness.

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Written by Li Liu Sheng
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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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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Principles of treatment for pyelonephritis

Pyelonephritis, also known as an upper urinary tract infection, is a bacterial inflammation, with over 95% being caused by bacterial infections, among which 70% are caused by Escherichia coli. Therefore, as a bacterial infection-induced inflammation, antibiotic treatment is of course necessary. Clinically, third-generation cephalosporins or fluoroquinolone antibiotics are often chosen for bactericidal treatment. For acute pyelonephritis, it is generally recommended that medication be administered for 14 days, alongside measures such as increased water intake and frequent urination. In cases of chronic pyelonephritis, a low-dose, long-course antibacterial treatment, such as using nitrofurantoin, may also be employed, with continuous medication for two months. (Please consult a clinical doctor for specific medication use; do not self-medicate.)

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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.