Pyelonephritis

Question 1

What is pyelonephritis?

Answer 1

Ascending bacterial infection in the upper urinary tract

- Kidneys, ureters, renal pelvis, parenchyma

Question 2

Is pyelonephritis acute or chronic?

Answer 2

Both

Question 3

What 2 microbes are usually the cause of pyelonephritis? What route do they enter the urinary tract via?

Answer 3

• E. coli via the urethra

- Staphylococcus aureus via the blood

Question 4

What are the risks for pyelonephritis?

Answer 4

• Compromised immune response
• Catheterization
• Urine stasis and reflux
• Diabetes mellitus
  
  • Increased glucose can be utilized by the bacteria
  • Causes vascular damage
    - Compromised circulation, IR, removal of waste

Question 5

Quick overview of the patho of pyelonephritis:

Answer 5

Bacteria enter urethra -> ascend to bladder -> then ureter -> kidneys -> infct -> inflm -> fibrosis + inflm damage -> decreased renal fx

Question 6

Quick overview of the patho of chronic pyelonephritis:

Answer 6

Same patho as acute pyelonephritis -> persistent inflm -> progressive renal damage -> renal failure

Question 7

What are the mnfts of pyelonephritis?

Answer 7

• Fever
• Pyuria
  
  • Pus in urine
• Lower back pain
• Dysuria
• Increased frequency
• Urgency
• Hypervolema
  
  • HTN if chronic
  • Edema

Question 8

What is the Tx for pyelonephritis?

Answer 8

• Abx (10-14 days)