Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. While lower UTIs are often uncomfortable but easily treatable, pyelonephritis tends to be more serious.
What is Pyelonephritis (kidney infection)?
When you think of a UTI, you probably think of a lower urinary tract infection that affects the bladder or urethra. However, UTIs can affect the kidneys. This happens when a urinary tract infection has traveled to the upper urinary tract (which includes the ureters and the kidneys). At this point, it is known as pyelonephritis. The most common type of renal disorder, pyelonephritis, may be chronic or acute.
In acute pyelonephritis, inflammation of the renal pelvis and calyces, where urine collects before draining into the bladder, can lead to abscesses and damage to urine-producing structures in the kidney. Treatment with antibiotics typically lasts one to three weeks, and while scar tissue forms, enough healthy tissue usually remains to preserve normal kidney function.
Chronic pyelonephritis results from bacterial infections in the kidneys over a period of years. Each episode of infection may pass unnoticed but may destroy more and more areas of tissue until the amount of functional kidney tissue is far less than the scar tissue that has formed. Active infections are treated with antibacterial drugs.
Kidneys play a significant role in the body. Their primary job is to filter waste from the bloodstream, producing urine that travels down the ureters and into the bladder. Because of this, an untreated infection can damage the kidneys and lead to long-term problems. In some rare cases, kidney infections can lead to serious medical conditions such as kidney disease, high blood pressure, or kidney failure. If kidney infection spreads to the bloodstream, it can cause a life-threatening problem called sepsis.
Women are more likely than men to get urinary tract infections and pyelonephritis. This is because a woman’s urethra is shorter than a man’s, so it is comparatively easier for bacteria to travel to the urinary tract organs.
Kidney infection symptoms
Most kidney infections begin as lower urinary tract infections, which worsen as they progress up the urinary tract. The symptoms of a UTI include:
- Painful, stinging, or burning sensation with urination (dysuria)
- Urinary frequency
- Persistent urge to urinate, even after the bladder has just been emptied
The symptoms of a urinary tract infection, plus these additional symptoms of a kidney infection, may indicate a case of pyelonephritis:
- High fever, chills, nausea, abdominal pain, and/or vomiting
- Lower back pain or flank pain
- Disorientation or confusion (especially in seniors)
- Changes in the urine (bloody, cloudy, or smelly)
What causes a kidney infection?
Pyelonephritis is usually caused by the same bacteria that causes typical urinary tract infections: the bacteria found in the colon. These bacteria can live on the skin surrounding the anus and can sometimes get into the urinary tract. Although our urinary system is designed to keep bacteria out, problems can occur.
Escherichia coli (E. coli) or other dangerous bacteria that can cause infectious diseases found in the intestines can enter the urinary tract through the urethra. In vesicoureteral reflux, where the urine flows backward toward the bladder, these bacteria can travel up into the bladder, which can cause cystitis. If the infection continues up to the kidneys, it can cause a kidney infection. This problem is rare, but it can be severe. 1 in every 30 cases of UTI leads to a kidney infection.
Risk factors for pyelonephritis
Certain factors can increase the risk of developing a kidney infection. Including:
- Conditions that cause urine to flow the wrong way. Normally flow of urine goes only in one direction—from the kidneys to the bladder. If the flow of urine goes backward, infections can occur.
- Urinary tract blockage. If the flow of urine is blocked, infections can occur. Urine flow can be blocked due to urinary tract abnormalities, tumors in the abdomen or pelvis, enlarged prostate, bladder, ureter, or kidney stones.
- A weakened immune system. Individuals with diabetes or other health conditions that cause a suppressed immune system are at high risk for infections. Pregnant women with UTIs can also be at risk and should be seen by their healthcare provider and treated as soon as possible. Kidney infection in a pregnant woman can be very serious.
- Having a urinary catheter. Catheters, used to drain the bladder, can be used after a surgical procedure, for a diagnostic test, or for individuals confined to a bed.
Diagnosing pyelonephritis
If you’re experiencing signs of kidney infection, make an appointment with your doctor immediately. Your doctor will conduct a physical examination and may perform one or more tests to confirm your diagnosis.
- Urinalysis. A urine sample is evaluated under a microscope. Too many white blood cells or bacteria can indicate an infection.
- Urine culture. Bacteria from the urine sample can be grown to help identify the type of bacteria within your urinary tract.
- Blood tests. A blood test may be ordered in addition to a urine test because a bacterial infection in the blood culture may indicate severe or acute pyelonephritis.
- Ultrasound. An ultrasound can detect stones or other masses in your pelvis.
- Computed tomography (CT) scan. CT scans use X-rays to create a 3-D image of your internal organs, which can help diagnose pyelonephritis.
Kidney infection treatment
Because pyelonephritis is a potentially serious condition, doctors recommend medical care immediately. Fortunately, a seven-day regimen of oral antibiotics can be very effective, and most patients can take them at home. Common antibiotics include ceftriaxone, trimethoprim, sulfamethoxazole, ciprofloxacin, and levofloxacin. However, patients who are vomiting will not be able to keep oral antibiotics medications down. In these cases, intravenous antibiotics may be recommended.
Complications of kidney infections
Complications can occur if pyelonephritis is left untreated or the infection is severe.
Abscesses are small “pockets” of infected tissue that can sometimes form in serious cases of pyelonephritis. They must be drained through a tube inserted through the skin and kidney. If the infection is not treated promptly, blood poisoning can occur, and the bacteria from the infection can spread throughout the body.
Although most cases of pyelonephritis occur on a singular basis and do not persist after successful treatment, some patients may suffer from chronic pyelonephritis.
Chronic pyelonephritis usually results from a congenital disability in the kidneys characterized by extensive scarring and degeneration. The condition is usually found in children. If you or your child is diagnosed with chronic pyelonephritis, your doctor will refer you to a specialist in renal care, such as a kidney specialist (nephrologist) or urinary surgeon (urologist).
How can you prevent a kidney infection?
There are ways you can lower your chances of getting a kidney infection. The following ways to prevent pyelonephritis may be helpful to women in particular.
- Hydration. Drinking fluids, primarily water, can help eliminate bacteria when urinating.
- Pay attention to cues. Urinate as soon as you feel the urge, and avoid holding urine for long periods.
- Use the bathroom after intercourse. Emptying the bladder after intercourse can help flush bacteria from the urethra.
- Wipe from front to back. Carefully wiping from front to back can prevent bacteria from entering the urethra.
Experiencing Urinary Symptoms? Talk to Dr. Aliabadi
Dr. Aliabadi isn’t only an expert OB/GYN but is knowledgeable in all aspects of women’s health and well-being, including UTIs. Dr. Aliabadi and her caring, supportive staff are available to support you through menopause, childbirth, infertility, or even just routine gynecological care.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Kidney Infection (Pyelonephritis) FAQs
What is the best antibiotic for kidney infection?
Your urine culture will tell your doctor which antibiotic is best for the specific bacteria causing your kidney infection.
Where is kidney pain felt in females?
Women usually feel kidney pain under their ribs, on the right or left side of the spine. They may also experience lower back or pelvic pain.
Can a kidney infection clear up on its own?
Lower UTI symptoms may occasionally clear up on their own, but kidney infections can cause severe complications if untreated and often require antibiotics.
SOURCES:
Acute Pyelonephritis https://www.ncbi.nlm.nih.gov/books/NBK519537
Recurrent Urinary Tract Infections https://www.ncbi.nlm.nih.gov/books/NBK557479
Urinary tract infections https://www.womenshealth.gov/a-z-topics/urinary-tract-infections
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