Acute pyelonephritis: causes, symptoms, treatment

Acute infectious inflammatory disease of the calyxal and pelvic system and renal tissue is called acute pyelonephritis.

It can develop on its own, but sometimes it occurs against the background of another, already existing kidney disease.

For the emergence of acute pyelonephritis, the infection must penetrate the kidneys and for this it has two ways.

Causes of pyelonephritis



The most common is the ascending path through the urinary tract. Here, bacteria enter the bladder through the ureter into the parenchyma and the renal pelvis. If there are colonies of intestinal enterobacteria in the perineum, this leads to the development of acute pyelonephritis.

Less common is pyelonephritis, caused by bacteria, which have passed the second way - with the help of hematogenous spread. In this case, there should be some other source of infection, it can be tuberculosis, or staphylococcal septicemia. Pyelonephritis reflux, urinary tract obstruction, kidney stone, diabetes mellitus, neurogenic bladder, immunosuppression may contribute to the development of acute pyelonephritis. In addition, factors such as pregnancy, congenital anomalies and even long-term catheter drainage are important.

Symptoms of acute pyelonephritis



Acute pyelonephritis in the majority begins with an increase in temperature to 39 0 With and chill, to this are added and pains in the lower back. Sometimes you can observe painful and frequent urination, and this is already evidence of the inflamed urethra and bladder.

The diagnosis of acute pyelonephritis is established in a hospital after a comprehensive examination. Take into account and laboratory data, you may also have to undergo instrumental examinations.

Treatment of acute pyelonephritis



The main method of treatment of acute pyelonephritis is antibacterial therapy, and with adequate treatment acute pyelonephritis can be cured already in the first days of illness.

For effective conservative treatment of acute pyelonephritis, antibacterial drugs are prescribed for a period of at least a month and a half, with a change every week and a half, and it does not matter that all manifestations of the disease, including changes in the urine, can disappear within a few days.

However, in the future, after curing the disease, you should lead a lifestyle with limited physical activity, fear catarrhal diseases and prevent possible cooling.

If the antibacterial treatment of acute pyelonephritis it appears to be ineffective, toxicosis grows, sharp pains continue in the kidneys site, anuria develops, and suspicions of a blockage of the ureter appear, and a number of other dangerous signs require urgent medical examination, after which, perhaps, there will be a need for surgery to eliminate the inflammatory-purulent process in the affected kidney. It is necessary to prevent the spread of infection to a healthy kidney.

Purulent pyelonephritis



One of the phases of the development of pyelonephritis, it is pyelitis, which is an inflammation of the renal pelvis, affecting the bowl-pelvis system. But after the renal pelvic reflux, the infection also penetrates the parenchyma of the kidney, and then purulent inflammation destroys the kidney tissue.

There are several forms of acute purulent pyelonephritis:

  • interstitial purulent pyelonephritis,

  • apostematous pyelonephritis,

  • carbuncle,

  • kidney abscess.


  • At the primary acute pyelonephritis, local signs are very weakly expressed. There is a serious condition of the patient, general weakness and chills, a rise in temperature to almost 40 0 C, there is dry tongue, profuse sweat and pain in the whole body. Possible nausea and even vomiting, tachycardia.

    Secondary pyelonephritis, which is caused by a violation of the outflow of urine, in the acute phase is characterized by a change in the totality of symptoms. In this case, the deterioration occurs simultaneously with a sharp increase in pain in the lower back, or an attack of renal colic due to a violation of the outflow of urine. At the peak of painful sensations, there is a chill, followed by a heat and a sudden increase in temperature. Further, the temperature drops to subfebrile, and this is accompanied by profuse sweating, and renal pains decrease until disappearance. But if the obstruction to the outflow of urine is not eliminated, these several hours of improvement change is intensified by severe pain, after which the next attack of acute pyelonephritis occurs.