Pyelonephritis natural history, complications and prognosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Pyelonephritis }}
{{Pyelonephritis }}
{{CMG}}; {{AE}} {{USAMA}}


{{CMG}}
==Overview==
==Overview==
Pyelonephritis is serious condition requiring emergent medical management. Most individuals who are treated adequately with antibiotics do not undergo complications. A surgical management with removal of stone or obstructing tumour may sometimes be require dot prevent complications and prevent obstructive pyelonephritis and stop the course of chronic pyelonephritis. The most common complication of pyelonephritis is recurrent infections.<ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728  }} </ref><ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
Pyelonephritis is distressful condition requiring emergent medical management. Most individuals who are treated adequately with [[antibiotics]] do not have complications. A surgical management with removal of stone or obstructing [[tumor]] may sometimes be required to prevent complications and prevent obstructive pyelonephritis and stop the course of chronic pyelonephritis. The most common complication of pyelonephritis is recurrent [[Infection|infections]]. Most episodes of pyelonephritis are uncomplicated and are easily treatable. The prognosis of pyelonephritis varies depending on the type of pyelonephritis and on the timing and duration of treatment. The mortality in case of [[UTI]] is between 5% to 33%.


== Natural History==
== Natural History==
If left untreated, Pyelonephritis can lead to papillary necrosis and ultimately leading to scaring of the kidneys. This scaring can cause [[Renal failure]] in some cases. Abscess formation in or around the renal tissue is also possible. Pyelonephritis can prove fatal in some cases without treatment. The following factors influence the prevalance of pathogens in the kidneys: <ref name="pmid12767958">{{cite journal| author=Efstathiou SP, Pefanis AV, Tsioulos DI, Zacharos ID, Tsiakou AG, Mitromaras AG et al.| title=Acute pyelonephritis in adults: prediction of mortality and failure of treatment. | journal=Arch Intern Med | year= 2003 | volume= 163 | issue= 10 | pages= 1206-12 | pmid=12767958 | doi=10.1001/archinte.163.10.1206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12767958  }} </ref>
If left untreated, Pyelonephritis can lead to [[papillary necrosis]] and ultimately leading to scarring of the [[kidneys]]. This scarring can cause [[renal failure]] in some cases. [[Abscess]] formation in or around the renal tissue is also possible. Pyelonephritis can prove fatal in some cases without treatment. The following factors influence the prevalence of pathogens in the kidneys:<ref name="pmid12767958">{{cite journal| author=Efstathiou SP, Pefanis AV, Tsioulos DI, Zacharos ID, Tsiakou AG, Mitromaras AG et al.| title=Acute pyelonephritis in adults: prediction of mortality and failure of treatment. | journal=Arch Intern Med | year= 2003 | volume= 163 | issue= 10 | pages= 1206-12 | pmid=12767958 | doi=10.1001/archinte.163.10.1206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12767958 }} </ref><ref name="pmid14450231">{{cite journal| author=HUTCH JA| title=The role of the ureterovesical junction in the natural history of pyelonephritis. | journal=J Urol | year= 1962 | volume= 88 | issue=  | pages= 354-62 | pmid=14450231 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14450231  }} </ref><ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728  }} </ref><ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956 }} </ref>
*History of Pyelonephritis
*History of pyelonephritis
*Recent history of Hospitalisation
*Recent history of [[hospitalization]]
*Nephrolithiasis
*[[Nephrolithiasis]]
*Immunosupression
*[[Immunosuppression]]


==Complications==
==Complications==
Line 18: Line 17:


===Life threatening complications===
===Life threatening complications===
*[[kidney failure]]
*[[Kidney failure]]
*[[Sepsis]] and Septic metastasis to bones and endocardium<ref name="pmid986763">{{cite journal| author=Siroky MB, Moylan R, Austen G, Olsson CA| title=Metastatic infection secondary to genitourinary tract sepsis. | journal=Am J Med | year= 1976 | volume= 61 | issue= 3 | pages= 351-60 | pmid=986763 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=986763  }} </ref>
*[[Sepsis]] and septic [[metastasis]] to [[Bone (disambiguation)|bones]] and [[endocardium]]<ref name="pmid986763">{{cite journal| author=Siroky MB, Moylan R, Austen G, Olsson CA| title=Metastatic infection secondary to genitourinary tract sepsis. | journal=Am J Med | year= 1976 | volume= 61 | issue= 3 | pages= 351-60 | pmid=986763 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=986763  }} </ref>
*Peritonitis<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>
*[[Peritonitis]]<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>
===Other complications===
===Other complications===
*Papillary necrosis <ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
*[[Papillary necrosis]]<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>


*Emphysematous cystitis<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
*Emphysematous [[cystitis]]<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>


*Renal scaring<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*Renal scarring<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*Dilation of renal pelvis
*Dilation of [[renal pelvis]]
*Renal Atrophy<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*Renal [[atrophy]]<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*Sub actute-chronic interstitial nephritis<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*Sub actute-chronic [[interstitial nephritis]]<ref name="pmid2651759">{{cite journal| author=Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P et al.| title=Frequency of development of early cortical scarring in acute primary pyelonephritis. | journal=Kidney Int | year= 1989 | volume= 35 | issue= 2 | pages= 696-703 | pmid=2651759 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2651759  }} </ref>
*[[Chronic kidney disease]]
*[[Chronic kidney disease]]
*High blood pressure These problems usually occur in people with a structural problem in the urinary tract, kidney disease from other causes, or repeated episodes of pyelonephritis.
*[[High blood pressure]] (results from a structural problem in the [[Urinary system|urinary tract]] or repeated episodes of pyelonephritis)


*[[Bacteremia]] or [[Bacteriuria]] <ref name="pmid686015">{{cite journal| author=Lee BK, Crossley K, Gerding DN| title=The association between Staphylococcus aureus bacteremia and bacteriuria. | journal=Am J Med | year= 1978 | volume= 65 | issue= 2 | pages= 303-6 | pmid=686015 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=686015  }} </ref>
*[[Bacteremia]] or [[bacteriuria]]<ref name="pmid686015">{{cite journal| author=Lee BK, Crossley K, Gerding DN| title=The association between Staphylococcus aureus bacteremia and bacteriuria. | journal=Am J Med | year= 1978 | volume= 65 | issue= 2 | pages= 303-6 | pmid=686015 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=686015  }} </ref>
*[[sepsis]], spread of the infection in the kidneys to the bloodstream
*[[Sepsis]]
*[[Renal abscess]]<ref name="pmid9378929">{{cite journal| author=Dembry LM, Andriole VT| title=Renal and perirenal abscesses. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 663-80 | pmid=9378929 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378929  }} </ref><ref name="pmid4913271">{{cite journal| author=Fair WR, Higgins MH| title=Renal abscess. | journal=J Urol | year= 1970 | volume= 104 | issue= 1 | pages= 179-83 | pmid=4913271 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4913271  }} </ref><ref name="pmid10102326">{{cite journal| author=Yen DH, Hu SC, Tsai J, Kao WF, Chern CH, Wang LM et al.| title=Renal abscess: early diagnosis and treatment. | journal=Am J Emerg Med | year= 1999 | volume= 17 | issue= 2 | pages= 192-7 | pmid=10102326 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10102326  }} </ref>   
*[[Renal abscess]]<ref name="pmid9378929">{{cite journal| author=Dembry LM, Andriole VT| title=Renal and perirenal abscesses. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 663-80 | pmid=9378929 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378929  }} </ref><ref name="pmid4913271">{{cite journal| author=Fair WR, Higgins MH| title=Renal abscess. | journal=J Urol | year= 1970 | volume= 104 | issue= 1 | pages= 179-83 | pmid=4913271 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4913271  }} </ref><ref name="pmid10102326">{{cite journal| author=Yen DH, Hu SC, Tsai J, Kao WF, Chern CH, Wang LM et al.| title=Renal abscess: early diagnosis and treatment. | journal=Am J Emerg Med | year= 1999 | volume= 17 | issue= 2 | pages= 192-7 | pmid=10102326 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10102326  }} </ref>   


*[[Perinephric abscess]],it is made by cortical staphylococcal renal abscess (Graves RC, Parkins LE. Carbuncle of the kidney. J Urol (Baltimore) 1970; 104:179.) or by rupturing of a renal abscess (Hill GS. Renal infection. In: Uropathology, 1st Ed, Hill GS (Ed), Churchill Livingstone, New York 1989; 33.)<ref name="pmid9378929">{{cite journal| author=Dembry LM, Andriole VT| title=Renal and perirenal abscesses. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 663-80 | pmid=9378929 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378929 }} </ref><ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728 }} </ref><ref name="pmid7039139">{{cite journal| author=Saiki J, Vaziri ND, Barton C| title=Perinephric and intranephric abscesses: a review of the literature. | journal=West J Med | year= 1982 | volume= 136 | issue= 2 | pages= 95-102 | pmid=7039139 | doi= | pmc=1273539 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7039139  }} </ref>
*[[Perinephric abscess]] made by cortical staphylococcal renal abscess or by rupture of a renal [[abscess]]<ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728 }} </ref><ref name="pmid9378929">{{cite journal| author=Dembry LM, Andriole VT| title=Renal and perirenal abscesses. | journal=Infect Dis Clin North Am | year= 1997 | volume= 11 | issue= 3 | pages= 663-80 | pmid=9378929 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9378929 }} </ref><ref name="pmid7039139">{{cite journal| author=Saiki J, Vaziri ND, Barton C| title=Perinephric and intranephric abscesses: a review of the literature. | journal=West J Med | year= 1982 | volume= 136 | issue= 2 | pages= 95-102 | pmid=7039139 | doi= | pmc=1273539 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7039139  }} </ref>


*AA [[Amyloidosis]]
*[[Amyloidosis]]


*Iliopsoas abscess <ref name="pmid27974344">{{cite journal| author=Kawamoto A, Sato R, Takahashi K, Luthe SK| title=Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis. | journal=BMJ Case Rep | year= 2016 | volume= 2016 | issue=  | pages=  | pmid=27974344 | doi=10.1136/bcr-2016-218541 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27974344  }} </ref>
*Iliopsoas [[abscess]]<ref name="pmid27974344">{{cite journal| author=Kawamoto A, Sato R, Takahashi K, Luthe SK| title=Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis. | journal=BMJ Case Rep | year= 2016 | volume= 2016 | issue=  | pages=  | pmid=27974344 | doi=10.1136/bcr-2016-218541 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27974344  }} </ref>


*Peritoneal abscess<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>
*Peritoneal [[abscess]]<ref name="pmid27915241">{{cite journal| author=Yeow Y, Chong YL| title=Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 12 | pages=  | pmid=27915241 | doi=10.1093/jscr/rjw211 | pmc=5159021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27915241  }} </ref>


==Prognosis==
==Prognosis==
The prognosis of pyelonephritis varies depending on the type of pyelonephritis and on the timing and duration of treatment.<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
* Most episodes of pyelonephritis are uncomplicated and are easily treatable. The prognosis of pyelonephritis varies depending on the type of pyelonephritis and on the timing and duration of treatment.<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
===Mortality===
 
*The mortality in case of UTI is between 5% to 33%.<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
*The mortality in case of [[UTI]] is between 5% to 33%.<ref name="pmid20121956">{{cite journal| author=Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G et al.| title=Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis. | journal=J Am Geriatr Soc | year= 2009 | volume= 57 | issue= 11 | pages= 2125-8 | pmid=20121956 | doi=10.1111/j.1532-5415.2009.02550.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20121956  }} </ref>
*Acute Pyelonephritis has a mortality of 10-20%.<ref name="pmid2017629">{{cite journal| author=Roberts FJ, Geere IW, Coldman A| title=A three-year study of positive blood cultures, with emphasis on prognosis. | journal=Rev Infect Dis | year= 1991 | volume= 13 | issue= 1 | pages= 34-46 | pmid=2017629 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2017629  }} </ref><ref name="pmid3310074">{{cite journal| author=Ispahani P, Pearson NJ, Greenwood D| title=An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom. | journal=Q J Med | year= 1987 | volume= 63 | issue= 241 | pages= 427-40 | pmid=3310074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3310074  }} </ref>
*Acute pyelonephritis has a mortality of 10-20%.<ref name="pmid2017629">{{cite journal| author=Roberts FJ, Geere IW, Coldman A| title=A three-year study of positive blood cultures, with emphasis on prognosis. | journal=Rev Infect Dis | year= 1991 | volume= 13 | issue= 1 | pages= 34-46 | pmid=2017629 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2017629  }} </ref><ref name="pmid3310074">{{cite journal| author=Ispahani P, Pearson NJ, Greenwood D| title=An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom. | journal=Q J Med | year= 1987 | volume= 63 | issue= 241 | pages= 427-40 | pmid=3310074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3310074  }} </ref>
*Type 1 emphysematous pyelonephritis has a mortality of 69% while type 2 emphysematous pyelonephritis has a mortality of 18%<ref name="pmid8596845">{{cite journal| author=Wan YL, Lee TY, Bullard MJ, Tsai CC| title=Acute gas-producing bacterial renal infection: correlation between imaging findings and clinical outcome. | journal=Radiology | year= 1996 | volume= 198 | issue= 2 | pages= 433-8 | pmid=8596845 | doi=10.1148/radiology.198.2.8596845 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596845  }} </ref>
*Type 1 [[emphysematous pyelonephritis]] has a mortality of 69% while type 2 [[emphysematous pyelonephritis]] has a mortality of 18%.<ref name="pmid8596845">{{cite journal| author=Wan YL, Lee TY, Bullard MJ, Tsai CC| title=Acute gas-producing bacterial renal infection: correlation between imaging findings and clinical outcome. | journal=Radiology | year= 1996 | volume= 198 | issue= 2 | pages= 433-8 | pmid=8596845 | doi=10.1148/radiology.198.2.8596845 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596845  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 23:54, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Pyelonephritis is distressful condition requiring emergent medical management. Most individuals who are treated adequately with antibiotics do not have complications. A surgical management with removal of stone or obstructing tumor may sometimes be required to prevent complications and prevent obstructive pyelonephritis and stop the course of chronic pyelonephritis. The most common complication of pyelonephritis is recurrent infections. Most episodes of pyelonephritis are uncomplicated and are easily treatable. The prognosis of pyelonephritis varies depending on the type of pyelonephritis and on the timing and duration of treatment. The mortality in case of UTI is between 5% to 33%.

Natural History

If left untreated, Pyelonephritis can lead to papillary necrosis and ultimately leading to scarring of the kidneys. This scarring can cause renal failure in some cases. Abscess formation in or around the renal tissue is also possible. Pyelonephritis can prove fatal in some cases without treatment. The following factors influence the prevalence of pathogens in the kidneys:[1][2][3][4]

Complications

Pyelonephritis can lead to the following complications:[1][5][6]

Life threatening complications

Other complications

Prognosis

  • Most episodes of pyelonephritis are uncomplicated and are easily treatable. The prognosis of pyelonephritis varies depending on the type of pyelonephritis and on the timing and duration of treatment.[4]

References

  1. ↑ 1.0 1.1 Efstathiou SP, Pefanis AV, Tsioulos DI, Zacharos ID, Tsiakou AG, Mitromaras AG; et al. (2003). "Acute pyelonephritis in adults: prediction of mortality and failure of treatment". Arch Intern Med. 163 (10): 1206–12. doi:10.1001/archinte.163.10.1206. PMID 12767958.
  2. ↑ HUTCH JA (1962). "The role of the ureterovesical junction in the natural history of pyelonephritis". J Urol. 88: 354–62. PMID 14450231.
  3. ↑ 3.0 3.1 Hoverman IV, Gentry LO, Jones DW, Guerriero WG (1980). "Intrarenal abscess. Report of 14 cases". Arch Intern Med. 140 (7): 914–6. PMID 6992728.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G; et al. (2009). "Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis". J Am Geriatr Soc. 57 (11): 2125–8. doi:10.1111/j.1532-5415.2009.02550.x. PMID 20121956.
  5. ↑ Anderson KA, McAninch JW (1980). "Renal abscesses: classification and review of 40 cases". Urology. 16 (4): 333–8. PMID 7414775.
  6. ↑ Fowler JE, Perkins T (1994). "Presentation, diagnosis and treatment of renal abscesses: 1972-1988". J Urol. 151 (4): 847–51. PMID 8126807.
  7. ↑ Siroky MB, Moylan R, Austen G, Olsson CA (1976). "Metastatic infection secondary to genitourinary tract sepsis". Am J Med. 61 (3): 351–60. PMID 986763.
  8. ↑ 8.0 8.1 Yeow Y, Chong YL (2016). "Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess". J Surg Case Rep. 2016 (12). doi:10.1093/jscr/rjw211. PMC 5159021. PMID 27915241.
  9. ↑ 9.0 9.1 9.2 Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P; et al. (1989). "Frequency of development of early cortical scarring in acute primary pyelonephritis". Kidney Int. 35 (2): 696–703. PMID 2651759.
  10. ↑ Lee BK, Crossley K, Gerding DN (1978). "The association between Staphylococcus aureus bacteremia and bacteriuria". Am J Med. 65 (2): 303–6. PMID 686015.
  11. ↑ 11.0 11.1 Dembry LM, Andriole VT (1997). "Renal and perirenal abscesses". Infect Dis Clin North Am. 11 (3): 663–80. PMID 9378929.
  12. ↑ Fair WR, Higgins MH (1970). "Renal abscess". J Urol. 104 (1): 179–83. PMID 4913271.
  13. ↑ Yen DH, Hu SC, Tsai J, Kao WF, Chern CH, Wang LM; et al. (1999). "Renal abscess: early diagnosis and treatment". Am J Emerg Med. 17 (2): 192–7. PMID 10102326.
  14. ↑ Saiki J, Vaziri ND, Barton C (1982). "Perinephric and intranephric abscesses: a review of the literature". West J Med. 136 (2): 95–102. PMC 1273539. PMID 7039139.
  15. ↑ Kawamoto A, Sato R, Takahashi K, Luthe SK (2016). "Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-218541. PMID 27974344.
  16. ↑ Roberts FJ, Geere IW, Coldman A (1991). "A three-year study of positive blood cultures, with emphasis on prognosis". Rev Infect Dis. 13 (1): 34–46. PMID 2017629.
  17. ↑ Ispahani P, Pearson NJ, Greenwood D (1987). "An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom". Q J Med. 63 (241): 427–40. PMID 3310074.
  18. ↑ Wan YL, Lee TY, Bullard MJ, Tsai CC (1996). "Acute gas-producing bacterial renal infection: correlation between imaging findings and clinical outcome". Radiology. 198 (2): 433–8. doi:10.1148/radiology.198.2.8596845. PMID 8596845.

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