aka Kidney Infection (pyelonephritis),
glomerulonephritis,
Definition:
Pyelonephritis = a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys.
Glomerulonephritis = a type of kidney disease that damages your kidney’s ability to remove waste and excess fluids
Etiology and PathophysiologyAffects the renal pelvis and parenchymaInfection develops in scattered areas and
spreads from renal pelvis to cortexKidney becomes edematousAbscesses may develop Tissue destruction primarily affects the
tubulesScar tissue replaces normal tissue and
affected tubules atrophy
E-coli is the most common causeProteus and Klebsiella bacteria are less
commonAcute form: usually caused by bacterial
infectionChronic form: associated with nonbacterial
infections such as metabolic, chemical, or immunologic disorders.
Vesicoureteral reflux
Symptoms of Kidney InfectionFeverBack, flank, or groin painAbdominal painFrequency in urinationStrong urge to urinateBurning or pain on urinationPus or blood in the urine
Causes of Kidney InfectionTypically occurs when bacteria enters the
urinary tract through the urethraBacteria from infection elsewhere in the body
can spread through the bloodstream and infect the kidneys.
Rarely, after kidney surgery
Risk FactorsFemale anatomyPoor hygieneObstruction in the urinary tractWeakened immune systemDamage to nerves around the bladderProlonged use of a urinary catheterUrine flowing the wrong wayCongenital malformationsDiabetes mellitus
Complications of Kidney InfectionPermanent kidney damageSepticemiaPregnancy complications
Tests and TreamentsUrine studies: urinalysis and urine culture;
24-hour urine collection, clean catch urine specimen or urinary catheterization (creatinine clearance, or protein)
Ultrasonography: size, shape and positionBlood studies: BUN, Serum creatinine
clearance
Treatment MEDICATIONS
Antimicrobials – Sulfonamides (Bactrim; Septra)
Antispasmodics – Phenazopyridine (Pyridium)Urine color is reddish-orangeStains clothing
Analgesics – Acetaminophen, Ibuprofen
**lots of choices, these are examples of each
Non-Pharmacologic therapiesApply heat
If a heating pad is used, it should only be set on low and used for 30-45 minutes and then removed for 1 hour. (the rebound phenomenon kicks in if used for a longer period of time).
Hydration – helps flush bacteria from the body (no caffeine, citrus or alcohol until the infection has cleared (these products promote urgency and frequency)
PreventionDrink plenty of fluids, especially waterUrinate frequentlyEmpty the bladder after intercourseAvoid feminine products in the genital areaUse proper hygiene
GlomerulonephritisA type of kidney disease that damages the
kidneys’ ability to remove waste and excess fluids
PrimarySecondary
Signs and SymptomsCola-colored or ice-tea-colored urineFoamy urineHigh blood pressureFluid retention (edema)FatigueLess frequent urination than usual
CausesFrequently unknown
Infections:Post-streptococcal glomerulonephritisBacterial endocarditisViral infections
Immune DiseasesLupusGoodpasture’s syndromeIgA nephropathy
VasculitisPolyarteritisWegener’s granulomatosis
Conditions that cause scarring of the glomeruliHTNDiabetic kidney diseaseFocal segmental glomerulosclerosis
ComplicationsAcute Kidney FailureChronic Kidney FailureHigh Blood PressureNephrotic Syndrome
Tests and DiagnosisBlood tests = creatinine, BUNUrinalysis Kidney BiopsyImaging tests
IVP (kidney x-ray)CT Scan(computerized tomography scan)
Treatment and DrugsTreatment is dependent on:
Whether you have an acute or chronic form of the disease.
The underlying causeThe type and severity of your signs and
symptoms
To control HTN and slow the decline of kidney function:DiureticsAngiotensin-converting enzyme (ACE)
inhibitorsAngiotensin II receptor agonists
Treatment of Underlying Causes
R/T bacterial infections = appropriate antibiotic
R/T Lupus or Vasculitis = corticosteroids and immune-suppressing drugs
R/T IgA nephropathy = fish oil supplements are under study
Goodpasture’s syndrome = Plasmapheresis
Patient EducationSeek prompt treatment of a strep infection
causing a sore throat or impetigoTo prevent infections such as HIV and
hepatitis, use safe sex practices and avoid IV drug use
Control blood sugar to help prevent diabetic nephropathy
Control your blood pressure