Is pyelonephritis serious?

Written by Zhou Qi
Nephrology
Updated on January 03, 2025
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Pyelonephritis, also known as an upper urinary tract infection, occurs in the majority of cases when bacteria enter the renal pelvis and calices, causing an inflammatory response. This condition is indeed characterized by severe symptoms and an aggressive onset. Patients may suddenly develop a fever, with temperatures even exceeding 39°C, and experience back pain. Some patients may also exhibit clinical signs such as hematuria. The symptoms are indeed severe, and there is a pronounced systemic inflammatory response, leaving patients feeling listless, dizzy, headachy, and lacking appetite. However, the treatment for this disease generally yields good results. After antibiotic treatment, most patients can gradually see symptom relief within 3 to 5 days, and the condition is mostly curable after 10 to 14 days of medication.

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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 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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How do you get pyelonephritis?

Pyelonephritis, also known as upper urinary tract infection, is an inflammatory response caused by pathogens; 95% of pyelonephritis is caused by bacterial infections. Most cases involve bacteria from the urethral opening ascending into the urinary system to reach the kidneys, where they proliferate and cause inflammatory symptoms. Normally, there are bacteria present at the human urethral opening. Under normal immune function or absence of factors like significant urinary obstruction, it is unlikely for an upward bacterial infection to occur. However, under certain conditions, this type of infection may happen, prompting an inflammatory response from the pathogens.

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Written by Zhou Qi
Nephrology
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The difference between pyelonephritis and nephritis

Pyelonephritis and nephritis are two completely different concepts. Pyelonephritis is actually a bacterial inflammation, usually caused by bacteria at the urethral opening ascending into the urinary system and causing inflammation in areas like the renal pelvis and calyces. Patients may experience symptoms such as fever, hematuria, and back pain. In severe cases, it can cause necrosis of the renal papillae, leading to acute renal failure. Some patients may also develop perinephric abscesses, which are caused by bacterial infections. Nephritis, on the other hand, refers to inflammation within the glomeruli. This type of inflammation does not involve bacteria and is related to disorders in the body’s immune function. The disordered immune response is aggressive, attacking the glomerular filtration barrier, leading to proteinuria and hematuria. Therefore, the mechanisms of disease and treatment methods for the two conditions are different.

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Written by Zhou Qi
Nephrology
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Is pyelonephritis easy to treat?

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.