How is pyelonephritis treated?

Written by Li Liu Sheng
Nephrology
Updated on December 20, 2024
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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.)

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Written by Zhou Qi
Nephrology
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Is pyelonephritis serious?

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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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 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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Written by Niu Yan Lin
Nephrology
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The difference between pyelonephritis and nephritis

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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Written by Zhou Qi
Nephrology
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What foods to eat for pyelonephritis

Pyelonephritis is not nephritis, but a type of bacterial infection. Therefore, as a bacterial infection, there are no specific dietary restrictions for patients. Such patients should ensure adequate intake of fluids, with a recommended daily urine output of over 2000ml. This can help flush the urinary system and wash away some bacteria, reducing bacterial proliferation. Since it involves inflammation, it is advisable to follow a lighter diet, avoiding spicy, stimulating, and greasy foods, and focusing on easily digestible and warm foods.