Pyelonephritis
Disease Details
Family Health Simplified
- Description
- Pyelonephritis is a type of urinary tract infection that affects the kidneys.
- Type
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Pyelonephritis is generally a type of urinary tract infection (UTI) that affects the kidneys. It is primarily bacterial in nature, commonly caused by Escherichia coli (E. coli).
Pyelonephritis is not typically associated with genetic transmission. It is more commonly caused by ascending infections from the lower urinary tract, although predisposing anatomical or functional abnormalities, which may have a genetic component, can increase susceptibility. - Signs And Symptoms
- Signs and symptoms of acute pyelonephritis generally develop rapidly over a few hours or a day. It can cause high fever, pain on passing urine, and abdominal pain that radiates along the flank towards the back. There is often associated vomiting.Chronic pyelonephritis causes persistent flank or abdominal pain, signs of infection (fever, unintentional weight loss, malaise, decreased appetite), lower urinary tract symptoms and blood in the urine. Chronic pyelonephritis can in addition cause fever of unknown origin. Furthermore, inflammation-related proteins can accumulate in organs and cause the condition AA amyloidosis.Physical examination may reveal fever and tenderness at the costovertebral angle on the affected side.
- Prognosis
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The prognosis for pyelonephritis varies depending on several factors including the patient's overall health, the severity of the infection, how quickly treatment is initiated, and whether there are any underlying conditions like urinary tract abnormalities or immunosuppressive disorders.
With prompt and appropriate antibiotic treatment, the prognosis is generally good, and most patients recover fully without complications. Chronic or recurrent pyelonephritis, however, can lead to more serious outcomes such as kidney damage or sepsis, particularly in individuals with predisposing factors. - Onset
- The onset of pyelonephritis is typically acute, meaning the symptoms develop rapidly. The infection often starts suddenly with symptoms such as high fever, chills, flank pain, painful urination, nausea, and vomiting.
- Prevalence
- Pyelonephritis is a bacterial infection of the kidneys. Accurate and current prevalence data can vary, but it is a relatively common condition, especially among women. In the United States, it is estimated that there are about 15 to 17 cases per 10,000 females per year and about 3 to 4 cases per 10,000 males per year.
- Epidemiology
- There are roughly 12–13 cases annually per 10,000 population in women receiving outpatient treatment and 3–4 cases requiring admission. In men, 2–3 cases per 10,000 are treated as outpatients and 1–2 cases/10,000 require admission. Young women are most often affected. Infants and the elderly are also at increased risk, reflecting anatomical changes and hormonal status. Xanthogranulomatous pyelonephritis is most common in middle-aged women. It can present somewhat differently in children, in whom it may be mistaken for Wilms' tumor.
- Intractability
- Pyelonephritis, an infection of the kidneys, is generally not considered intractable. It typically responds well to appropriate antibiotic therapy. However, complications can arise if the infection is severe, recurrent, or not adequately treated. In such cases, more intensive medical intervention may be required.
- Disease Severity
- Pyelonephritis is a serious bacterial infection of the kidneys that can vary in severity. In mild cases, it can be treated with oral antibiotics, but severe cases may require hospitalization and intravenous antibiotics. Potential complications can include kidney scarring, renal abscess, and sepsis if not treated promptly.
- Healthcare Professionals
- Disease Ontology ID - DOID:11400
- Pathophysiology
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Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. The pathophysiology of pyelonephritis involves the following steps:
1. **Bacterial Invasion**: The most common cause of pyelonephritis is the ascent of bacteria from the lower urinary tract, such as the bladder, through the ureters to the kidneys. E. coli is the most frequently implicated pathogen.
2. **Colonization and Ascension**: Bacteria colonize the bladder and, facilitated by factors such as vesicoureteral reflux or urinary obstruction, ascend to the kidneys.
3. **Inflammatory Response**: Once in the renal pelvis and parenchyma, the bacteria trigger an inflammatory response. This includes the infiltration of neutrophils, release of cytokines, and activation of the complement system.
4. **Tissue Damage**: The inflammation and immune response can lead to tissue damage in the renal medulla and cortex, causing renal swelling, abscess formation, and, in severe cases, renal scarring.
5. **Clinical Manifestation**: Patients typically present with symptoms such as fever, flank pain, dysuria, increased urinary frequency, and urgency. They may also exhibit signs of systemic infection.
6. **Complications**: If untreated, pyelonephritis can lead to complications like chronic kidney disease, sepsis, and renal abscesses.
Rapid diagnosis and treatment with appropriate antibiotics are crucial to preventing these adverse outcomes. - Carrier Status
- Pyelonephritis is an infection of the kidney and its ducts. It is not a condition associated with a carrier status.
- Mechanism
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Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. Here's a detailed view of its mechanism and molecular mechanisms:
**Mechanism:**
1. **Infection Ascension:** Pyelonephritis typically begins as a lower urinary tract infection (cystitis) and ascends through the ureters to the kidneys.
2. **Bacterial Entry:** The most common causative agent is Escherichia coli (E. coli), which enters the urinary tract via the urethra and travels upward.
3. **Immune Response:** The body mounts an immune response to the infection, resulting in inflammation. Neutrophils and other immune cells infiltrate the renal parenchyma.
4. **Tissue Damage:** Inflammation and immune reactions cause tissue damage in the kidneys, leading to symptoms such as fever, flank pain, and in severe cases, renal abscesses.
**Molecular Mechanisms:**
1. **Adhesion Factors:** E. coli and other uropathogens possess adhesins (e.g., P fimbriae, type 1 fimbriae) that facilitate attachment to the uroepithelium, helping the bacteria resist urine flow and establish infection.
2. **Toxins:** Bacterial toxins such as hemolysin and cytotoxic necrotizing factor 1 can damage host tissues and suppress immune responses.
3. **Uropathogenic E. coli (UPEC) Pathogenesis:** UPEC strains have pathogenicity islands (PAIs) that carry genes for virulence factors, including iron acquisition systems (e.g., siderophores), which help them thrive in the iron-limited environment of the urinary tract.
4. **Host Immune Evasion:** Uropathogens can evade the host immune system by mechanisms such as intracellular bacterial communities (IBCs) and biofilm formation, which protect them from immune cells and antibiotics.
5. **Inflammatory Response:** Activation of the host's innate immune system through pattern recognition receptors (PRRs) such as Toll-like receptors (TLRs) recognizes bacterial components (e.g., lipopolysaccharides). This leads to the release of cytokines and chemokines, orchestrating the inflammatory response.
Understanding these mechanisms is crucial for developing targeted treatments for pyelonephritis. - Treatment
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Pyelonephritis is typically treated with antibiotics. The choice of antibiotic and the duration of treatment depend on the severity of the infection and whether it is a complicated or uncomplicated case. Commonly prescribed antibiotics include:
1. Ciprofloxacin
2. Levofloxacin
3. Trimethoprim-sulfamethoxazole
4. Amoxicillin-clavulanate
For mild to moderate cases, a course of oral antibiotics for 7-14 days is common. Severe cases may require hospitalization and intravenous antibiotics initially, followed by oral antibiotics once the patient stabilizes. It's also important to stay hydrated and manage pain or fever with medications like acetaminophen or ibuprofen as needed. Follow-up is essential to ensure the infection has fully resolved. - Compassionate Use Treatment
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For pyelonephritis, compassionate use or experimental treatments might be considered in severe or resistant cases where standard treatments are not effective. Off-label or experimental treatments may include:
1. **Combination Therapy**: Using a combination of different antibiotics not traditionally used together might be attempted, especially for multidrug-resistant infections.
2. **Phage Therapy**: This treatment uses bacteriophages (viruses that infect bacteria) to target specific pathogenic bacteria and is an area of active research.
3. **New Antibiotics**: Investigational antibiotics, which are still in clinical trials, might be used under compassionate use protocols.
It's critical to discuss these options with a healthcare provider specialized in infectious diseases, as they are not standard first-line treatments and have varying levels of evidence and regulatory approval. - Lifestyle Recommendations
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For pyelonephritis, the following lifestyle recommendations can support treatment and prevent recurrence:
1. **Hydration**: Drink plenty of water to help flush bacteria from your urinary tract.
2. **Hygiene**: Practice good personal hygiene to reduce bacterial spread, such as wiping from front to back after using the toilet.
3. **Urination Habits**: Urinate frequently and do not hold urine for extended periods. Also, urinate after sexual activity to help clear out bacteria.
4. **Diet**: Maintain a balanced diet rich in fruits, vegetables, and whole grains while avoiding excessive intake of refined sugars and fats.
5. **Avoid Irritants**: Steer clear of irritating substances like caffeine, alcohol, and spicy foods that can aggravate the bladder.
6. **Probiotics**: Consider probiotic supplements or foods like yogurt to support a healthy urinary tract flora.
7. **Clothing**: Wear loose-fitting clothing and breathable fabrics, such as cotton, to reduce moisture build-up that can promote bacterial growth.
If symptoms persist or worsen, it is important to seek medical attention promptly for appropriate treatment. - Medication
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For treating pyelonephritis, antibiotics are the primary medication. Commonly used antibiotics include:
- **Ciprofloxacin**
- **Levofloxacin**
- **Trimethoprim-sulfamethoxazole**
- **Ceftriaxone**
The choice of antibiotic depends on several factors, including the severity of the infection, the patient's medical history, and local antibiotic resistance patterns. Hospitalization and intravenous antibiotics may be necessary for severe cases. Always consult a healthcare provider for appropriate diagnosis and treatment. - Repurposable Drugs
- There is no current information or specific list of non-antibiotic drugs repurposed specifically for pyelonephritis treatment. However, the management of pyelonephritis primarily involves the use of antibiotics to eradicate the bacterial infection.
- Metabolites
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Pyelonephritis is an infection of the kidney typically caused by bacteria. When it comes to metabolites, the inflammatory and immune responses in the body can lead to specific metabolic changes. Key metabolites that may be altered include:
1. **Creatinine**: Elevated due to impaired kidney function.
2. **Urea**: Increased levels can occur with impaired kidney filtration.
3. **C-reactive protein (CRP)**: Increased due to inflammation.
4. **White blood cells (WBC)**: Elevated due to infection.
These metabolites can be measured to assess the severity and impact of pyelonephritis on kidney function. - Nutraceuticals
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For pyelonephritis, there is no substantial evidence supporting the effectiveness of nutraceuticals (food-derived products offering health benefits) as a primary treatment. Standard care typically involves antibiotic therapy. However, certain nutraceuticals may help support general urinary tract health, potentially reducing the risk of infection:
1. **Cranberry Extract**: Some studies suggest cranberry extract may prevent bacteria from adhering to the urinary tract lining, potentially reducing infection risk.
2. **Probiotics**: Probiotics like Lactobacillus species might help maintain a healthy balance of urinary microbiota.
3. **D-Mannose**: A type of sugar that may help prevent E. coli bacteria from attaching to the urinary tract walls.
Always consult with a healthcare provider before starting any nutraceuticals for pyelonephritis. - Peptides
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For pyelonephritis, peptides refer to small chains of amino acids that may be studied for their potential therapeutic or diagnostic roles. Research is ongoing to explore their ability to target and manage bacterial infections, including those that cause pyelonephritis.
"Nan" is unclear in this context. It could be a typo or refer to nanotechnology, which involves manipulating matter on a molecular or atomic scale. Nanotechnology applications in pyelonephritis are also under investigation, particularly in enhancing drug delivery systems to improve treatment effectiveness and reduce bacterial resistance.