Is pyelonephritis easy to treat?

Written by Zhou Qi
Nephrology
Updated on September 16, 2024
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Most cases of pyelonephritis start acutely, with patients abruptly experiencing bacterial infections in their urinary system, causing inflammation in areas such as the renal pelvis and calyces. This manifests clinically with symptoms such as fever and back pain. This acute onset type is called acute pyelonephritis, and it is relatively easy to treat because it involves a bacterial infection that requires antibacterial treatment. Hence, it is generally manageable. However, if a patient's condition becomes prolonged and turns into chronic pyelonephritis, treatment may be more challenging. The bacteria causing chronic pyelonephritis are often drug-resistant, and this condition might be associated with predisposing factors for urinary infections, such as urinary system stones, anatomical abnormalities of the urinary tract, or obstructions that can conceal bacteria or contribute to their resistance, making treatment more difficult.

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Written by Zhou Qi
Nephrology
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Principles of treatment for pyelonephritis

Pyelonephritis, also known as an upper urinary tract infection, is a bacterial inflammation, with over 95% being caused by bacterial infections, among which 70% are caused by Escherichia coli. Therefore, as a bacterial infection-induced inflammation, antibiotic treatment is of course necessary. Clinically, third-generation cephalosporins or fluoroquinolone antibiotics are often chosen for bactericidal treatment. For acute pyelonephritis, it is generally recommended that medication be administered for 14 days, alongside measures such as increased water intake and frequent urination. In cases of chronic pyelonephritis, a low-dose, long-course antibacterial treatment, such as using nitrofurantoin, may also be employed, with continuous medication for two months. (Please consult a clinical doctor for specific medication use; do not self-medicate.)

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Nephrology
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Acute Pyelonephritis Nursing Measures

Acute pyelonephritis, also known as an upper urinary tract infection, is a type of bacterial inflammation. In terms of care, patients should first focus on increasing their fluid intake. If the patient does not have urinary system stones, tumors, or other factors causing urinary obstruction—that is, if there is no kidney hydronephrosis—it is recommended that the patient's daily urine output be maintained at 2000-2500 milliliters. This means increasing fluid intake can help flush the urinary system, reducing bacterial growth and reproduction, which is beneficial for the treatment of pyelonephritis. Secondly, since the patient has acute inflammation, dietary considerations should include eating light, avoiding heavy and greasy foods as well as spicy and stimulating foods, and paying attention to perineal hygiene. Additionally, during episodes of fever, if the patient's body temperature is not very high, a warm water sponge bath can be given, especially focusing on the neck, armpits, and the root of the thighs, which can facilitate heat dissipation and is very beneficial for reducing body temperature.

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How to diagnose pyelonephritis?

For the diagnosis of pyelonephritis, it is first necessary to confirm the diagnosis. Generally, patients should first undergo routine urine tests. In these tests, the presence of white blood cells and positive nitrites, along with clinical symptoms such as back pain, blood in urine, and fever are common. A routine blood test often shows elevated white blood cells and C-reactive protein. These indicators together suggest the presence of pyelonephritis. Furthermore, a culture of a clean-catch midstream urine sample can be done. If the bacteria grow to a certain quantity, it can also help in confirming the diagnosis of pyelonephritis. Additionally, to assess complications associated with pyelonephritis, it is necessary to perform blood tests for kidney function and an ultrasound of the urinary system to rule out conditions such as acute renal failure, renal papillary necrosis, and perinephric abscess, among others.

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Nephrology
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How to check for pyelonephritis?

Pyelonephritis, also known as upper urinary tract infection, is mostly caused by bacterial infection and the inflammatory response of the urinary system. The screening for this disease involves routine urine tests. Presence of white blood cells in the urine, coupled with symptoms like fever and back pain, can lead to a preliminary diagnosis. However, to confirm the diagnosis and identify the specific infecting pathogen, a culture of midstream urine is needed. Generally, to exclude certain causes of pyelonephritis, it is also necessary for the patient to have blood sugar levels checked and an ultrasound of the urinary system conducted. These tests can confirm whether the patient has diabetes, urinary system stones, or obstructions in the urinary system. Male patients can also undergo a prostate ultrasound to rule out urinary obstruction caused by prostate enlargement. These examinations can also help determine why the patient might have developed pyelonephritis.

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Can pyelonephritis be cured?

Whether pyelonephritis can be cured mainly depends on whether the patient has predisposing factors for urinary tract infections. These factors primarily include: Firstly, abnormalities in the anatomical structure of the urinary tract that may lead to obstruction of urine excretion, such as urological system stones, tumors, prolonged indwelling catheters, congenital abnormalities of the urinary system, and others. Additionally, there are some conditions that may lead to a decreased immune response, such as elderly individuals who are bedridden, those with diabetes, or patients using immunosuppressants. If the aforementioned factors are present, treatment of such cases of pyelonephritis might be challenging, with patients possibly experiencing recurrent episodes and potentially progressing to chronic pyelonephritis, eventually becoming difficult to cure completely. However, if none of these factors exist, the majority of cases with simple acute pyelonephritis can be cured and controlled by medication.