Kidney infection or Kidney infection or pyelonephritis pyelonephritis Definition Definition : : Pyelonephritis Pyelonephritis is an is an infection of the kidney and infection of the kidney and the urethres the urethres . . Causes Causes 1- urinary tract 1- urinary tract infection, in the presence of infection, in the presence of occasional or persistent back occasional or persistent back flow flow 2 2 - - urine from the bladder into urine from the bladder into the ureters or kidney pelvis the ureters or kidney pelvis ( ( vesicoureteric reflux vesicoureteric reflux ) ) . .
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Kidney infection or Kidney infection or pyelonephritispyelonephritis
DefinitionDefinition:: Pyelonephritis Pyelonephritis is an infection of is an infection of
the kidney and the urethresthe kidney and the urethres . .CausesCauses 1- urinary tract infection, 1- urinary tract infection,
in the presence of occasional or in the presence of occasional or persistent back flowpersistent back flow
22--urine from the bladder into the urine from the bladder into the ureters or kidney pelvis ureters or kidney pelvis ((vesicoureteric refluxvesicoureteric reflux)) . .
Classification of Classification of pyelonephritispyelonephritis
Acute uncomplicatedAcute uncomplicated
pyelonephritispyelonephritis sudden sudden development of kidney development of kidney inflammationinflammation.).)
Chronic pyelonephritisChronic pyelonephritis (a long- (a long-standing infection that does standing infection that does notnot clearclear
Causes incidence, and Causes incidence, and risk factorsrisk factors
The risk is increased if there is a The risk is increased if there is a history ofhistory of cystitis, renal papillary cystitis, renal papillary necrosis, kidney stones, necrosis, kidney stones, vesicoureteric reflux, or obstructive vesicoureteric reflux, or obstructive uropathyuropathy . .
Acute pyelonephritisAcute pyelonephritis can be severe in can be severe in the elderly and in people who are the elderly and in people who are immunosuppressed (for example, immunosuppressed (for example, those with cancer or AIDS)those with cancer or AIDS)..
SymptomsSymptoms:: - -Flank pain or back painFlank pain or back pain . .
- -Severe abdominal painSevere abdominal pain- - high fever and persists for more than 2 high fever and persists for more than 2
daysdays . .- - Chills with shaking.Warm, flushed, Chills with shaking.Warm, flushed,
- - Fatigue and general ill feelingFatigue and general ill feeling . .- - Painful urination, urinary frequency or Painful urination, urinary frequency or
urgency nocturiaurgency nocturia ,. ,.- - Cloudy or abnormal urine color, foul or Cloudy or abnormal urine color, foul or
strong urine odor, and hematuria may strong urine odor, and hematuria may occuroccur . .
- - Mental changes of confusionMental changes of confusion
Diagnostic studiesDiagnostic studies
--A urinalysisA urinalysis commonly reveals commonly reveals white blood cells (WBCs) or red white blood cells (WBCs) or red blood cells (RBCs)blood cells (RBCs) . .
--A urine cultureA urine culture may reveal bacteria may reveal bacteria in the urinein the urine . .
--A blood cultureA blood culture may show an may show an infectioninfection . .
--An intravenous pyelogram (IVP) or An intravenous pyelogram (IVP) or CT scanCT scan of the abdomen may show of the abdomen may show enlarged kidneys with poor flow of enlarged kidneys with poor flow of dye through the kidneysdye through the kidneys . .
TreatmentTreatment
The goals of treatment are control The goals of treatment are control of the infection and reduction of of the infection and reduction of symptomssymptoms . .
Acute symptoms usually resolve within Acute symptoms usually resolve within 48 to 72 after appropriate treatment48 to 72 after appropriate treatment . .
Due to the high mortality rate in the Due to the high mortality rate in the elderly population and the risk of elderly population and the risk of permanent kidney damage prompt permanent kidney damage prompt treatment is recommendedtreatment is recommended . .
antibiotics are selected to treat the antibiotics are selected to treat the infectioninfection..
Intravenous (IV) antibioticsIntravenous (IV) antibiotics may be used may be used initially to control the bacterial infection if initially to control the bacterial infection if infection is severe a infection is severe a 10- to 14 day10- to 14 day course course of antibiotics chronic pyelonephritisof antibiotics chronic pyelonephritis
Kidney damageKidney damage can result from these can result from these infections. The elederly, infants, and infections. The elederly, infants, and people with a compromised immune people with a compromised immune systemsystem
soso receive frequent monitoring for receive frequent monitoring for
potential problems and to receive IV potential problems and to receive IV antibiotics, additional IV fluids and other antibiotics, additional IV fluids and other medications as necessarymedications as necessary
ComplicationsComplications:: Recurrence of pyelonephritisRecurrence of pyelonephritis . .Perinephric abscess (infection Perinephric abscess (infection
around the kidney)around the kidney) . .SepsisSepsis . .
preventionpreventionPrompt and complete treatment ofPrompt and complete treatment of
cystitis pyelonephritis. Chronic or recurrent cystitis pyelonephritis. Chronic or recurrent urinary tract infection of the kidneysurinary tract infection of the kidneys..
Preventive measuresPreventive measures may reduce may reduce
symptoms and prevent recurrence of symptoms and prevent recurrence of infection. Keeping the genital area clean infection. Keeping the genital area clean and remembering to from front to backand remembering to from front to back
Urinating immediatelyUrinating immediately after sexual after sexual intercourse may help eliminate any intercourse may help eliminate any bacteriabacteria
PreventionPrevention Increasing the intake of Increasing the intake of
fluidsfluids to encourage frequent to encourage frequent urination that flushes bacteria urination that flushes bacteria from the bladderfrom the bladder . .
Drinking cranberry juice Drinking cranberry juice prevents certain types of prevents certain types of bacteriabacteria from attaching to the from attaching to the wall of the bladderwall of the bladder
GlomerulonephritisGlomerulonephritis is an is an inflammation of the kidneyinflammation of the kidney’’s s filtering mechanisms, called the filtering mechanisms, called the glomeruliglomeruli . .
Glomerulonephritis can Glomerulonephritis can be acutebe acute, , which means it occurs suddenlywhich means it occurs suddenly,,
or chronicor chronic, meaning symptoms , meaning symptoms develop gradually and continue develop gradually and continue over a number of yearsover a number of years
commoncommon in children between the in children between the ages of 2 and 12, particularly boysages of 2 and 12, particularly boys..
Children with frequent streptococcal Children with frequent streptococcal infectionsinfections
people with diseases such as people with diseases such as hepatitis,, or diabeteshepatitis,, or diabetes..
What causes itWhat causes it occurs after a streptococcal occurs after a streptococcal
infection, such as strep throat- infection, such as strep throat- certain toxins, such as paintscertain toxins, such as paints
its cause is not knownits cause is not known ..
What are the signs & What are the signs & symptomssymptoms ?? often flu-like, such as general fatigue, nausea, vomiting, loss of appetite, fever,
and abdominal and joint pain. These types of general symptoms can continue for up to one month before symptoms of kidney failure appear
swelling. They can progress to high blood pressure, visual disturbances, shortness of breath, blood in the urine, and a reduction in urine production.
Chronic glomerulonephritis develops so gradually that it is often not discovered until a routine physical exam .
As this condition progresses, it causes high blood pressure, swelling, and other symptoms of kidney failure.
How is it diagnosedHow is it diagnosed- - complete medical history, physical complete medical history, physical
examination, and laboratory testsexamination, and laboratory tests . .- - check a urine samplecheck a urine sample for blood and for blood and
high levels of proteinhigh levels of protein check for high levels of the waste check for high levels of the waste
products creatinine and urea in bloodproducts creatinine and urea in blood . .If a streptococcal infectionIf a streptococcal infection is is
suspected, throat culture, will reveal suspected, throat culture, will reveal this bacteria. a biopsy, to study this bacteria. a biopsy, to study under a microscope. An under a microscope. An eye exameye exam may show signs of vascular changes may show signs of vascular changes in people with chronic in people with chronic glomerulonephritisglomerulonephritis..
the treatmentthe treatment bedrestbedrest and medicationsand medications
11--to cure any infection, increase urine to cure any infection, increase urine output, and lower blood pressureoutput, and lower blood pressure , ,
22 - -to relieve any strain on the kidneys to relieve any strain on the kidneys so they can recover full functionso they can recover full function
diet control to diet control to your intake of your intake of sodium, protein, and fluids. Most sodium, protein, and fluids. Most children recover fullychildren recover fully , ,
no treatmentno treatment to stop the to stop the progression of chronic progression of chronic glomerulonephritis. Once glomerulonephritis. Once kidney failure has occurredkidney failure has occurred , ,
waste productswaste products must be must be removed from the removed from the bloodstream for the kidneys bloodstream for the kidneys through a process called through a process called dialysisdialysis . .
A kidney transplantA kidney transplant may may also be an optionalso be an option..
You can help prevent acute You can help prevent acute glomerulonephritis by treating glomerulonephritis by treating streptococcal infections following streptococcal infections following the full course of medicationthe full course of medication
44--Patient educationPatient education (medication ,diet,avoidance of (medication ,diet,avoidance of trams ,infection &follow -uptrams ,infection &follow -up
Nephrotic syndromeNephrotic syndromeISIS condition marked by very high condition marked by very high
levels of protein in the urine; low levels of protein in the urine; low levels of protein in the blood; swellinglevels of protein in the blood; swelling
of Nephrotic syndromeof Nephrotic syndromeSymptoms of Nephrotic syndromeSymptoms of Nephrotic syndrome
Frothy urineFrothy urine ProteinuriaProteinuria
Low serum proteinLow serum protein LipiduriaLipiduria
Swelling around the eyesSwelling around the eyes
it it results fromresults from a specific glomerular a specific glomerular defect and indicates renal damage. The defect and indicates renal damage. The prognosis is highly variable, depending prognosis is highly variable, depending on the underlying cause. Some forms on the underlying cause. Some forms may progress to end-stage renal failuremay progress to end-stage renal failure . .
CausesCauses About 75% of nephrotic About 75% of nephrotic syndrome cases result from primary syndrome cases result from primary (idiopathic) glomerulonephritis(idiopathic) glomerulonephritis
11--Some tubules may contain increased Some tubules may contain increased lipid depositslipid deposits
22--lesion in patients with adult lesion in patients with adult idiopathicidiopathic . .
Other causes of nephroticOther causes of nephrotic
11--metabolic diseases such as metabolic diseases such as diabetes mellitusdiabetes mellitus ; ;
collagen-vascular disorders, such collagen-vascular disorders, such as as 22-systemic lupus -systemic lupus erythematosus and polyarteritiserythematosus and polyarteritis
33--circulatory diseases, such as circulatory diseases, such as heart failure and sickle cell heart failure and sickle cell anemia; anemia; 4-4-nephrotoxins, such as nephrotoxins, such as mercury, gold, and nonsteroidal mercury, gold, and nonsteroidal 5-5-anti-inflammatories; allergic anti-inflammatories; allergic reactions; infections, such as reactions; infections, such as tuberculosistuberculosis
DiagnosisDiagnosis Consistent proteinuriaConsistent proteinuria in excess of in excess of
examination of urineexamination of urine reveals an reveals an increased number of granular, and increased number of granular, and waxy, fatty casts, and oval fat bodieswaxy, fatty casts, and oval fat bodies . .
Serum valuesSerum values that support the that support the diagnosis are increased cholesterol, diagnosis are increased cholesterol, phospholipid, and triglyceride levels phospholipid, and triglyceride levels and decreased albumin levelsand decreased albumin levels . .
Histologic identificationHistologic identification of the of the lesion requires a kidney biopsylesion requires a kidney biopsy
TreatmentTreatment 11 - -correction ofcorrection of the underlying cause the underlying cause..
22--Supportive treatmentSupportive treatment consists of consists of protein replacement with a nutritional protein replacement with a nutritional diet of 1 g protein/kg of body weight, diet of 1 g protein/kg of body weight, with restricted sodium intakewith restricted sodium intake..
33--aa diuretic fordiuretic for edema; and an edema; and an antibiotic for infectionantibiotic for infection . .
44--ImmunosuppressantsImmunosuppressants, , antihypertensives, and diureticsantihypertensives, and diuretics . .
55--Angiotension-converting enzyme Angiotension-converting enzyme inhibitorsinhibitors can decrease protein loss in can decrease protein loss in urineurine
