The difference between pyelonephritis and nephritis

Written by Niu Yan Lin
Nephrology
Updated on September 30, 2024
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Pyelonephritis and nephritis are two completely different diseases. Pyelonephritis is an infectious disease caused by bacteria, viruses, mycoplasma, chlamydia, etc. Treatment generally requires the use of antibiotics. The vast majority of patients can fully recover within two weeks under the treatment of sensitive antibiotics, without any sequelae. On the other hand, nephritis is mostly an autoimmune disease, not an infectious disease caused by pathogens. Therefore, its treatment does not require the use of antibiotics. Treatment usually involves ACE inhibitors or ARB type RUSH blockers, glucocorticoids, immunosuppressants, cytotoxic drugs, etc., and the course of nephritis is relatively long, with some patients having relatively poor prognosis. (Please use medication under the guidance of a doctor.)

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Nephrology
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Symptoms of recurring pyelonephritis

Pyelonephritis is an upper urinary tract infection. When the condition recurs, the initial symptoms are similar. Patients may also experience fever, and the temperature can rise quickly, even up to 40 degrees Celsius. There may also be a systemic inflammatory response, characterized by fatigue and loss of appetite, among other symptoms. Recurrence can also cause pain in the lumbar region, which may even radiate to the perineal area, and patients may also experience visible hematuria. In urinalysis, leukocytes or positive leukocyte esterase can be observed. These are the symptoms of recurring pyelonephritis.

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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 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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How is pyelonephritis caused?

Pyelonephritis can also be referred to as an upper urinary tract infection. It occurs when bacteria proliferate in parts of the kidney such as the renal pelvis and calyces, leading to inflammation. In most cases, these bacteria enter the urinary system retrogradely from the urethral opening and cause inflammation in areas like the renal pelvis and calyces. Normally, bacteria are already present at the urethral opening, and when the body's immune system is functioning well and the urinary system is unobstructed, it is difficult for these bacteria to enter the urinary system and cause an inflammatory response. However, in patients with weakened immune systems, such as those suffering from a cold, diabetes, or those using steroid medications, bacteria may enter the urinary system and replicate in large numbers. Additionally, if there are obstructive factors in the urinary system, such as prostate enlargement in male patients, or if the patient has urinary system stones or tumors, bacteria are more likely to cause an inflammatory response.

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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.