Pyelonephritis

Question 1

pyelonephritis

Answer 1

• upper UTI
• pyelo refers to renal calyces and pelvis
• inflmtn of the renal pelvis and parenchyma
• acute or chronic forms

Question 2

etiology

Answer 2

d/t bacterial infection
usually E Coli
staphylococcus aureus via blood

Question 3

risks

Answer 3

• suppressed immunity
• catheterization
• urine stasis and reflux (ex. in BPH d/t compression of the prostate on the urethra)
• DM

Question 4

why is diabetes mellitus a risk?

Answer 4

inadequate perfusion leads to decreased defense cells and immunity, surface proteins become glycosylated and WBCs decrease function, as well as glycosuria providing nutrients for bacteria

Question 5

patho

Answer 5

• bacteria establish, proliferate and cause complx
• advance from urethra -> bladder -> ureter -> kidney (ascending infection and inflmtn along entire UT tract)
• kidney doesn’t have large amounts of empty space (as in bladder) so bacteria proliferates within tissue and damage parenchyma
• possibility of fibrosis and scar tissue -> kidney fx compromised

Question 6

chronic form

Answer 6

• self-perpetuating
• arise d/t lack of intervention, unsuccessful intervention, recurring infections, or progression from acute pyelonephritis
• reflux on an ongoing basis > recurring infections -> inflmtn
• irreversible renal damage can lead to renal failure

Question 7

manifestations

Answer 7

• abrupt onset
• fever
• lower back pain (in region of kidney)
• pyuria d/t presence of bacteria
• frequency, urgency, dysuria
• edema and severe HTN (if chronic)

Question 8

why do you have frequency, urgency and dysuria?

Answer 8

still producing urine but not proper volume, so you have decreased urine output

Question 9

why do you have edema and severe HTN?

Answer 9

d/t fluid retention causing an increase in blood volume and congestion

Question 10

treatment

Answer 10

• Abx (10-14 days)

- anti-inflammatories