Infectious Diseases 2022

Pyelonephritis: what é, symptoms, causes and treatment

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Pyelonephritis: what é, symptoms, causes and treatment
Pyelonephritis: what é, symptoms, causes and treatment

Pyelonephritis is an inflammation of the kidneys that usually occurs when bacteria present in the urinary tract ascend through the ureters and reach the kidneys, causing inflammation and leading to the appearance of some symptoms such as pain in the lower back, constant urge to urinate, fever, malaise and pelvic pain.

It is important that pyelonephritis is identified and treated quickly according to the urologist's recommendation, as it is possible to prevent inflammation from continuing to occur and resulting in loss of kidney function.

Symptoms of pyelonephritis

Symptoms of pyelonephritis develop as the bacteria proliferate in the kidneys and cause inflammation, the main ones being:

  • Lumbar and pelvic pain;
  • Abdominal pain;
  • Pain and burning when urinating;
  • Constant urge to urinate;
  • Smelly urine;
  • Disease;
  • Fever;
  • Chills and excessive sweating;
  • Nausea and vomiting;
  • Cloudy urine.

As the bacteria proliferate in the kidneys, there may be a progressive loss of kidney function due to intense inflammation, which can lead to kidney failure and, consequently, kidney failure.

Types of pyelonephritis

Pyelonephritis can be classified into two main types according to how it develops:

  • Acute pyelonephritis, when the infection appears suddenly and intensely, disappearing after a few weeks or days and compromising the functioning of the kidney, which can be reversible as long as the treatment is performed correctly;
  • Chronic pyelonephritis, which is characterized by recurrent bacterial infections that have not been cured well, causing prolonged and progressive inflammation in the kidney and severe damage that can lead to kidney failure and, later, kidney failure.

Thus, in the presence of signs and symptoms indicative of pyelonephritis, it is important that the urologist is consulted so that tests are carried out to help confirm the diagnosis and identify the microorganism responsible for the infection, making it possible to start the treatment more treatment, which usually involves the use of antibiotics.

Main causes

Pyelonephritis usually occurs as a result of an untreated urinary tract infection, in which bacteria present in the urinary tract travel up the ureters and settle in the kidneys, where they proliferate and cause inflammation.The main bacteria related to pyelonephritis are Escherichia coli, Proteus sp., Klebsiella sp. and Pseudomonas aeruginosa.

In addition, pyelonephritis can also be a consequence of a generalized infection, in which the bacteria that is causing infection in another organ, reaches the bloodstream and manages to reach the kidneys, where it remains, resulting in pyelonephritis.

This type of infection is more common in women due to the proximity between the anus and the urethra, which favors the occurrence of infections, however it can also happen more easily in people with high blood pressure, diabetes and in men with benign prostatic hyperplasia.

How the diagnosis is made

The diagnosis of pyelonephritis is made by the urologist through the evaluation of the symptoms presented by the person, physical examination and the result of a urinalysis to identify the presence of blood, leukocytes and bacteria in the urine, which is usually indicative of pyelonephritis.In addition, in some cases the doctor may recommend performing imaging tests such as X-ray, ultrasound and computed tomography to confirm the diagnosis.

A urine culture and antibiogram may also be requested by the physician in order to identify the agent causing pyelonephritis and establish the best line of treatment. Understand how urine culture is performed.

Treatment of pyelonephritis

Treatment of pyelonephritis is usually done with antibiotics according to the sensitivity profile of the microorganism and should start as soon as possible to prevent kidney damage and prevent bacteria from spreading through the bloodstream causing septicemia. In addition, to relieve pain, the doctor may indicate the use of analgesics and anti-inflammatories.

Acute pyelonephritis, when untreated, can favor the occurrence of septicemia, renal abscess, renal failure, hypertension and chronic pyelonephritis.In case of chronic pyelonephritis, severe kidney damage and kidney failure, in addition to the use of antibiotics, it may be necessary to have dialysis every week to filter the blood. When pyelonephritis is caused by obstruction or malformation of the kidney, surgery may be necessary to correct the problem.

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