Pyelonephritis Last updated: Jun 30, 2009

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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations

 
 

Pyelonephritis is a kidney infection, usually as a complication of a lower urinary tract infection (UTI). Pyelonephritis can be classified as either acute (uncomplicated pyelonephritis), chronic (a long-standing infection that does not clear) or reflux (an infection that occurs in the presence of an obstruction). Pyelonephritis occurs much less frequently than a bladder infection. The risk is increased if there is a history of cystitis or kidney stones. Acute pyelonephritis can be severe in the elderly and in people who are immunosuppressed. Until you are cured of the infection, avoid foods that might irritate the urinary tract and put undue stress on the kidneys. Food to avoid are alcohol, coffee, salt, black tea, chocolate, carbonated beverages, citrus fruits, tomatoes, spicy foods, vinegar, artificial sweeteners, and sugar are all considered potential irritants.

Prevention Prompt and complete treatment of cystitis, as well as prevention, will help to reduce the chance of getting a kidney infection.

  • Urinate as soon as possible when you feel the urge and empty your bladder completely and drink plenty of liquids.
  • Women should wipe from front to back to avoid spreading bacteria to the opening of the urethra. The most common bacteria responsible for kidney infections comes from feces.
  • Do not wear synthetic underwear that traps heat in the crutch area.
  • Empty your bladder after intercourse to flush any bacteria.
  • If you use a diaphragm, make sure that it fits properly and only leave it in for the required time - no longer.
  • Avoid using scented soaps, bubble baths, and vaginal deodorants.
The most common cause of pyelonephritis is the backward flow (reflux) of infected urine from the bladder to the upper urinary tract. Bacterial infections may also be carried to one or both kidneys through the bloodstream or lymph glands from infection that began in the bladder. Kidney infection sometimes results from urine that becomes stagnant due to obstruction of free urinary flow. A blockage or abnormality of the urinary system, such as those caused by stones, tumors, congenital deformities, or loss of bladder function from nerve disease, increases a person's risk of pyelonephritis. Other risk factors include diabetes mellitus, pregnancy, chronic bladder infections, a history of analgesic abuse, paralysis from spinal cord injury, or tumors. Catheters, tubes, or surgical procedures may also trigger a kidney infection.

Reflux nephropathy is a condition in which the kidneys are damaged by backward flow of urine into the kidney. Urine flows from the kidneys, through the ureters, and into the bladder. Each ureter has a one-way valve where it enters the bladder, preventing urine from flowing back up the ureter.

Reflux nephropathy occurs when these valve-like mechanisms between the ureters and bladder fail, allowing urine to flow back up to the kidney. If the bladder is infected or the urine contains bacteria, the kidney is exposed to the possibility of infection (pyelonephritis).

Because the pressure in the bladder is generally higher than that in the kidney, the reflux of urine exposes the kidney to unusually high pressure. Over time, this increased pressure will damage the kidney and cause scarring.

Reflux may occur in people whose ureters do not extend very far into the bladder. The ureters enter the bladder through "tunnels" in the bladder wall, and the pressure in the bladder normally keeps these tunnels pressed closed. If the bladder wall tunnels are short or absent, pressure within the bladder can force urine back up the ureter.

 
 

Signs, symptoms & indicators of Pyelonephritis:
 
 
Symptoms - Gas-Int - General  Unexplained nausea
  Unexplained vomiting

Symptoms - General
  Fatigue of recent onset

Symptoms - Metabolic
  Frequent 'chills' or having chills from an illness
  Having a moderate/having a high fever
 Kidney infection often results in a fever higher than 102F (38.9C) persisting for more than 2 days.

  Daytime sweating

Symptoms - Urinary
  Kidney pain
 Usually continuous pain that begins in the back above the waist and may spread down into the groin.

  (Very) painful urination
  Very cloudy urine
  Strong-smelling urine
  Frequent daytime urination
  Having blood in urine

Counter-indicators:
  Absence of urine odor
 
 

Conditions that suggest Pyelonephritis:
 
 
Symptoms - UrinaryCounter-indicators:
  Absence of kidney infection

Uro-Genital
  Nocturia
 
 

Risk factors for Pyelonephritis:
 
 
Infections  Mycoplasma Infection
 M.hominis has been found present in cases of pyelonephritis, kidney disease, and U.urealyticum which is more usually seen in urine samples, can be found in some types of bladder stones.
 
 

Pyelonephritis suggests the following may be present:
 
 
Emergency Care  A Potentially Urgent Medical Need
 
 

Pyelonephritis can lead to:
 
 
Uro-Genital  Nocturia
 
 

Recommendations for Pyelonephritis:
 
 
Diet  Increased Water Consumption
 Drinking enough water each day will help discourage kidney infections by reducing the chances that bacteria find their way up from the bladder into the kidneys. Water helps by flushing out your urinary tract. This flushing also helps to prevent formation of kidney stones, which is another risk factor for pyelonephritis.

Drug
  Antibiotics
 A kidney infection should not be left to resolve on its own, but should be treated aggressively. Because they are so serious, most naturopaths will insist that you seek conventional medical care.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Highly recommended







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Analgesic:  Agent which relieves pain without causing loss of consciousness.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Cystitis:  Inflammation of the urinary bladder.

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Diaphragm:  The muscle separating the stomach from the chest.

Kidney Stone:  A stone (concretion) in the kidney. If the stone is large enough to block the tube (ureter) and stop the flow of urine from the kidney, it must be removed by surgery or other methods. Also called Renal Calculus. Symptoms usually begin with intense waves of pain as a stone moves in the urinary tract. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin. The pain may continue if the stone is too large to pass; blood may appear in the urine and there may be the need to urinate more often or a burning sensation during urination. If fever and chills accompany any of these symptoms, an infection may be present and a doctor should be seen immediately.

Lymph Glands:  Located in the lymph vessels of the body, these glands trap foreign material and produce lymphocytes. These glands act as filters in the lymph system, and contain and form lymphocytes and permit lymphatic cells to destroy certain foreign agents.

Pyelonephritis:  Inflammation of the renal pelvis.

Reflux Nephropathy:  Reflux nephropathy occurs when the normally one-direction-only valve-like mechanisms between the ureters and bladder fail. This allows urine to flow back up the ureter directly to the kidney. If the bladder is infected or the urine contains bacteria this exposes the kidney to the possibility of infection (pyelonephritis).