Acute pyelonephritis

Acute pyelonephritis is an acute infectious and inflammatory disease of the kidney tissue and the pyelocaliceal system of the kidneys. It can be primary or develop against the background of an already existing other kidney disease.

The reasons

There are two routes for infection.

The ascending urinary tract is the most common. In this case, bacteria retrogradely enter from the bladder through the ureter into the renal pelvis and parenchyma. Colonization of the perineum by intestinal enterobacteria precedes the episode of acute pyelonephritis.

The second route of infection is hematogenous spread, which is less common. Usually, with all this, there is another extrarenal focus of infection, for example, tuberculosis and staphylococcal septicemia. Factors contributing to the development of acute pyelonephritis: urinary tract obstruction, vesicoureteral reflux, kidney stone, neurogenic bladder, diabetes mellitus, impaired general body resistance (immunosuppression), congenital anomalies, pregnancy, prolonged catheter drainage.


Acute pyelonephritis most often begins with chills with an increase in temperature to 39ºС and above, pain in the lower back is soon detected. Frequent and painful urination is observed inconsistently, which almost always indicates an associated inflammation of the bladder and urethra.


The diagnosis of acute pyelonephritis is established only in a hospital based on the results of a comprehensive examination, taking into account laboratory data, and, if necessary, instrumental studies.


The main place in the treatment of acute pyelonephritis is antibiotic therapy. With proper treatment, acute pyelonephritis can be stopped in the first days of the disease.

With effective conservative treatment, antibacterial products are prescribed for a period of at least 4-6 weeks with a change after 7-10 days, despite the fact that general and local manifestations, as well as changes in the urine, may disappear after a few days.

In the future, it is advisable to follow a lifestyle with limited physical activity, to prevent colds and colds.

In case of ineffective antibacterial treatment of acute pyelonephritis, which is manifested by increasing toxicosis, sharp pains in the kidney area, also with the development of anuria, suspected blockage of the ureter, with eye pyuria, carbuncle of the kidney, paranephritis, necrosis of the renal papillae, an urgent consultation with a doctor is necessary and, probably, surgical treatment to combat the inflammatory-purulent process in the affected kidney and prevent its spread to a healthy kidney.

Articles from the forum on the topic ” Acute pyelonephritis “

Acute pyelonephritis. Who had?

Answer #1

Acute pyelonephritis. Pyelonephritis, being at first a focal process, takes on a diffuse character with each new attack. Acute pyelonephritis is an acute non-specific (that is, caused not by any specific pathogen, but by many types of bacteria) inflammation of the kidney with a predominant lesion of the interstitial tissue of the kidney (its connective tissue frame ) and the pyelocaliceal system (the initial part of the urinary tract).

Acute pyelonephritis can occur at different ages, but more often it occurs in 20-40 years. In women, inflammation of the kidney usually occurs as a complication of inflammation of the bladder (cystitis), while in men, the infection in the kidney area is more often transferred through the bloodstream.

Acute pyelonephritis and its types
There are primary and secondary types of acute pyelonephritis. Such pyelonephritis is considered primary when it is not preceded by diseases of the kidneys and urinary tract, and secondary – if inflammation of the kidney occurs against the background of another urological disease, leading to a violation of the outflow of urine or to a disorder of blood and lymph circulation in the kidney. Acute pyelonephritis occurs at any age (10-15% of all kidney diseases), but most often they suffer from children and young women.… Treatment of acute pyelonephritis
Treatment of acute primary pyelonephritis is medical. Bed rest, plenty of fluids, easily digestible food are prescribed. In accordance with the results of a urine test for the sensitivity of infectious agents to antibacterial agents, antibiotics and other antimicrobial drugs are prescribed. With proper adequate treatment, the condition improves after 7-10 days, but antibiotic therapy is continued for at least 20 days. At the same time, general strengthening agents (vitamins and other biologically active substances), immunostimulants are prescribed.

Treatment of secondary pyelonephritis is, first of all, the restoration of a normal passage of urine with simultaneous antibacterial and restorative treatment. If the passage of urine was disturbed by a stone, then they try to advance and remove it in various ways (for example, by introducing a special stent – a catheter that expands the lumen of the ureter). If this fails, then it is promptly removed. With the progression of the purulent process, in some cases, they resort to the removal of the kidney.

Acute pyelonephritis is a serious disease that always requires careful examination and treatment of the patient.

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