Acute Pyelonephritis

Excerpt

Acute pyelonephritis is a bacterial infection causing renal inflammation and is one of the most common kidney diseases. Pyelonephritis generally occurs as a complication of an ascending urinary tract infection (UTI), which spreads from the bladder superiorly to the kidney, although the infection may also be spread hematogenously.

Symptoms usually include fever, flank pain, chills, nausea, vomiting, anorexia, burning on urination, increased frequency, and urgency. The most common acute pyelonephritis symptoms are usually fever and flank pain.

Acute pyelonephritis can be divided into complicated and uncomplicated types. Complicated pyelonephritis includes pregnant patients, patients with uncontrolled diabetes, kidney transplants, urinary anatomical abnormalities, acute or chronic kidney failure, as well as immunocompromised patients, and those with hospital-acquired bacterial infections. It is essential to distinguish between complicated and uncomplicated pyelonephritis, as patient management and disposition depend on it.

Chronic pyelonephritis refers to the disease process of pyogenic scarring and long-term inflammatory changes from persistent or recurrent renal infections, usually associated with vesicoureteral reflux or other significant urological anatomic abnormalities in children. In adults, it may describe the condition of an ongoing or intractable kidney infection associated with a major anatomical anomaly of the urinary tract, calculi, or an abnormal inflammatory response, such as in xanthogranulomatous pyelonephritis.