How to diagnose pyelonephritis?

Written by Zhou Qi
Nephrology
Updated on September 09, 2024
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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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Written by Zhou Qi
Nephrology
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Is pyelonephritis easy to treat?

Pyelonephritis is generally not difficult to treat. Because the condition often appears quite aggressive, it is caused by bacteria entering the urinary system through the urethra, leading to an inflammatory response. Therefore, the primary treatment involves using antibiotics to kill the bacteria. Most of the bacteria causing pyelonephritis are Gram-negative rods, so antibiotics sensitive to Gram-negative rods are often chosen. After a treatment course of 10-14 days, the patient's condition is generally controllable and curable. However, there are also a few cases of chronic pyelonephritis, involving complex factors related to urinary tract infections, such as urinary tract malformations, urinary system stones, prostate hyperplasia, diabetes, etc., which make treatment more difficult. (Medication should be used under the guidance of a doctor.)

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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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Written by Zhou Qi
Nephrology
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What causes acute pyelonephritis?

Acute pyelonephritis, also known as an upper urinary tract infection, occurs when certain pathogens enter the urinary system and cause inflammation in areas such as the renal pelvis and calyces. Patients typically exhibit symptoms such as fever, back pain, and may also experience visible blood in the urine. The condition often has a severe onset. The common pathogens causing this type of infection primarily include bacteria, fungi, and viruses, among which the vast majority of cases are caused by bacterial infections. Furthermore, Gram-negative bacilli constitute the majority of these bacteria, with Escherichia coli being the most common.

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Written by Zhou Qi
Nephrology
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Is pyelonephritis more serious or nephritis more serious?

Pyelonephritis is an upper urinary tract infection caused by a bacterial infection, leading to an inflammatory response in the urinary system. The severity of this condition can vary. Nephritis, on the other hand, refers to the sterile inflammation within the glomeruli of the kidney, which also varies in severity. Therefore, it is challenging to compare these two diseases in terms of their severity. In the case of pyelonephritis, most conditions are relatively more treatable, and using antibiotics can control acute pyelonephritis. However, a small number of patients may develop severe complications such as perinephric abscess, acute renal failure, renal papillary necrosis, and even death from septic shock. The severity of nephritis also varies, with symptoms ranging from significant proteinuria to mild hematuria. Therefore, a comparison should be based on the specific conditions of the patients. (The use of medications should be under the guidance of a doctor.)

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Written by Li Liu Sheng
Nephrology
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How is pyelonephritis treated?

Whether it is the treatment of acute pyelonephritis or chronic pyelonephritis, first of all, personal hygiene should be emphasized, physical fitness should be enhanced, water intake should be increased, and urination should be frequent. In addition, for patients with acute pyelonephritis, the main treatment is the use of sensitive antibiotics, which can be either semi-synthetic penicillin or cephalosporins, and fluoroquinolone antibiotics can also be used. For chronic pyelonephritis, if the patient has urinary anatomical or functional abnormalities, such as the presence of urinary stones or urinary obstruction, active surgical treatment can be considered to relieve the obstruction. Furthermore, patients with chronic pyelonephritis who also have hypertension and edema can appropriately use antihypertensive drugs and diuretics to control blood pressure and edema, which can play a role in protecting kidney function. (The use of medications should be conducted under the guidance of a doctor.)