Pyelonephritis (Kidney Infection)

What is pyelonephritis?

Pyelonephritis is bacterial infection of one or both kidneys. Kidney infection can be serious because it can permanently damage the kidneys. Also, the infection may enter the bloodstream and cause life-threatening infection. Another problem is that it can cause pregnant women to go into labor too early (premature labor).

Kidney infections are much more common in women than men.

How does it occur?

Kidney infections usually start in the bladder or the urethra, which is the tube that empties urine from the bladder. Bladder infections can happen when bacteria travel from the vagina or rectal area (anus) into the urethra and bladder. The bacteria travel up to the kidneys from the bladder. In men, the infection might also start as a prostate infection. Bacteria can also spread to the kidneys from an infection somewhere else in the body.

The urinary system is a common site of birth defects. If your urinary system is abnormal, you have a greater risk that a bladder infection will spread to the kidneys.

Kidney stones increase the risk of infection.

What are the symptoms?

The symptoms range from mild to severe. They may include:

• fever
• chills or sweats
• abdominal or back pain
• loss of appetite
• nausea or vomiting
• problems with urination, such as pain when you urinate or a frequent urge to urinate.

Sometimes it is hard to know whether urinary symptoms are caused by an infection of the lower urinary tract (for example, the bladder) or by a kidney infection. The symptoms should not be ignored. If you have symptoms, see your healthcare provider right away. A bladder infection can quickly lead to pyelonephritis. The infection can spread to the bloodstream. Do not wait to get treatment.

How is it diagnosed?

Your healthcare provider will review your medical history, looking especially for current or recent lower urinary tract infection. You will also have a physical exam. Your provider will check for pain in the kidney area. A sample of your urine will be tested in the lab.

How is it treated?

Antibiotic medicine is the main treatment for a kidney infection. You may be able to start your treatment at home. You may be able to keep being treated at home if your symptoms seem to be getting better within 24 hours after you start taking the medicine. If you are more seriously ill, or if the medicine does not seem to be working well, you may need to be in the hospital. There you can be given fluids and medicine through an IV.

Usually you will need to take an antibiotic for at least 7 days. All bacteria must be killed to prevent kidney damage and to keep the infection from coming back.

Your antibiotic may need to be changed after the first day or two of treatment if lab tests of the bacteria in your urine show a different antibiotic will work better. Your healthcare provider will tell you if this is the case.

If you have an abnormal urinary tract or stones in your urinary tract, you may need surgery.

How long do the effects last?

How long it takes to get better depends on how severe your symptoms are when you start treatment. In mild cases, you will start feeling better in the first 1 or 2 days. It may take several days if you have a more severe infection.

With proper treatment there are usually no complications of pyelonephritis. If you keep having symptoms, or your symptoms come back soon after you finish your treatment, you may need more tests. Your healthcare provider will check for another cause of the infection or to see if another antibiotic is needed.

How can I take care of myself?

• Follow the treatment plan your healthcare provider prescribes.
• If you have a fever:
  • Ask your healthcare provider if you should take aspirin or acetaminophen for the fever. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
  • Keep a daily record of your temperature.
• Notice whether your symptoms get better within 1 to 2 days after you start taking the antibiotic.
• Drink plenty of fluids.
• Take your medicines exactly as your provider tells you to.
• Tell your provider right away about any symptoms that get worse or come back.
• Follow your healthcare provider's directions for a follow-up urine test. Your provider may want to test your urine soon after you finish taking the antibiotic.

Call your provider if you have new or worsening:

• fever
• chills or sweats
• abdominal or back pain
• nausea or vomiting
• problems with urination, such as pain when you urinate or a frequent urge to urinate
• blood in your urine.

How can I help prevent pyelonephritis?

The best way to prevent kidney infections is to try to prevent bladder infections.

Women can take the following steps to try to prevent bladder infections:

• Drink plenty of water and other beverages.
• Practice good hygiene when you use the toilet, such as wiping from front to back.
• Avoid using irritating cosmetics or chemicals in the area of the vagina and urethra, such as strong soaps and scented sanitary napkins or panty liners.
• Urinate to empty your bladder after you have sex.

Men can take the following steps to try to prevent bladder infections:

• Drink plenty of water and other beverages.
• Practice good genital hygiene. If you are a man who has not been circumcised, good hygiene includes gently pulling back the foreskin to wash the tip of the penis every time you bathe or shower.
• Urinate to empty your bladder after you have sex.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File urin5357.htm Release 13/2010