Pyelonephritis

Question 1

“Pyelo”?

Answer 1

refers to renal calices and pelvis

Question 2

“pyro?”

Answer 2

fever

Question 3

“Pyo?”

Answer 3

pus

Question 4

Pyelonephritis?

Answer 4

Inflammation of renal pelvis and parenchyma (functional tissue)

Question 5

Is pyelonephritis an acute or chronic condition?

Answer 5

Could be both

Question 6

Etiology of pyelonenephritis?

Answer 6

• almost exclusively d/t bacterial infection

- variety of bacteria are responsible: usually E. Coli, Staphylococcus aureus via blood

Question 7

Risks of pyelonephritis?

Answer 7

• suppressed immunity
• catheterization
• urinary reflux
• diabetes mellitus

Question 8

Explain how urinary reflux can cause pyelonephritis.

Answer 8

Eg. in BPH d/t compression of prostate on the urethra

Question 9

Explain how diabetes mellitus can cause pyelonephritis.

Answer 9

Inadequate perfusion leads to decrease defense cells and immunity, surface proteins become glycosylated and WBC’s decrease function, as well as glycosuria providing nutrients for bacteria.

Question 10

Explain the patho of pyelonephritis.

Answer 10

It is a typical bacterial infection. Bacteria establish, proliferate and cause complications. Advance from the urethra -> bladder -> ureter -> kidney (ascending infection and inflammation alone the entire urinary tract) -> kidney does not have large amounts of empty space (as in the bladder) so bacteria proliferate within the tissue and damage the parenchyma. Possibility of fibrosis and scar tissue (nonfunctional tissue) -> decreases the function of the kidney {prevented with quick intervention}

Question 11

Chronic of pyelonephritis

Answer 11

• self-perpetuating
• arise d/t lack of intervention, unsuccessful intervention, recurring infections or porgression from acute pyelonephritis
• reflux on an ongoing basis -> recurring infections -> chronic inflm
• irreversible renal damage will potentially lead to renal failure

Question 12

Manifestations of pyelonephritis.

Answer 12

• abrupt onset
• pain is more severe than lower UTI -> lower back pain (in region of the kidney)
• infection -> impacting vital organ -> fever
• frequency, dysuria, urgency
• pyuria d/t presence of bacteria
• edema and HTN d/t retention of fluid

Question 13

What are possible complications of pyelonephritis?

Answer 13

• Edema and HTN d/t retention of fluid because decreased kidney function results in decreased ability to excrete fluid (increased blood volume and you end up with HTN)

Question 14

Treatment of pyelonephritis?

Answer 14

• antibiotics (10-14 days)
• anti-inflammatories
• symptomatic management