Pyelonephritis Kidney infection

Pyelonephritis is an inflammatory process of the kidney, usually caused by a bacterial infection, being one of the most frequent kidney pathologies.

In the vast majority of cases, pyelonephritis originates from the upward migration of bacteria, along the urinary tract, to the renal parenchyma, giving rise to an acute infectious process. Some pathologies of the urinary tract may favor the upward migration of bacteria, as is the case of obstructive (benign prostatic hyperplasia or urethral stenosis) or functional (neurogenic bladder) pathologies.

On the other hand, although much less frequently in recent decades, pyelonephritis may originate in the migration of bacteria from adjacent organs or through the bloodstream, as is with genitourinary tuberculosis.

As for symptoms, the usual clinical picture consists of symptoms of a low urinary tract infection (dysuria, increased urinary frequency, change in the color or smell of urine), associated with low back pain, fever, chills, nausea or vomiting.

Regarding the clinical presentation, pyelonephritis can manifest itself with a relatively mild condition (uncomplicated pyelonephritis) or with a more severe condition (complicated pyelonephritis), which can eventually culminate in a generalized infection (urosépsis), which is potentially deadly.

Complementary diagnostic tests are important, not only for diagnosis and treatment purposes, but also to identify conditions that favor the appearance of urinary infections or to exclude other pathologies that may present similar symptoms. In this way, clinical analysis (urinary sediment, urine culture, blood count, C-reactive protein) and imaging tests (renal ultrasound, bladder ultrasound with measurement of post-voiding residue, Renal Computed Tomography) may be performed.

Treatment depends on the severity of the clinical condition, and implies taking antibiotics; hospitalization and even surgical procedures may also be required, such as an urinary diversion with ureteral stent (placement of a catheter between the kidney and the bladder, through the urethra), or nephrostomy (percutaneous placement of a catheter in the kidney, through the lower back). In more severe cases, abscess drainage may be necessary.