Pyelonephritis risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Most risk factors of Pyelonephritis are similar to those for Cystitis or Urinary tract infections, since they themselves predispose the individual to Pyelonephritis. Common risk factors in the development of pyelonephritis include renal calculi, urinary tract catheterization, pregnancy, diabetes mellitus, and benign prostatic hyperplasia.[1]
Risk Factors
Risk is increased in the following situations:[2][3][4][5][6][7][8][9]
Mechanical/Anatomical
Any structural abnormalities of the kidneys and the urinary tract can lead to abnormal accumulation of bacteria that can ascend to the kidneys to cause pyelonephritis.
- Kidney Stones calculi
- vesicoureteral reflux (VUR) abnormality in the mechanism that normally prevents backward flow or reflux of urine. VUR is most commonly diagnosed during childhood.
- Posterior urethral valve
- pregnancy
- urinary tract catheterization or stents
- drainage procedures (e.g. nephrostomy), post surgical VUR
- prostate disease (e.g. benign prostatic hyperplasia) in men
- Polycystic Kidney
- Bladder neck obstruction
- Horseshoe kidney
- Ureterocele
- neuropathic bladder (e.g. due to spinal cord damage, spina bifida or multiple sclerosis)
- Incontinenece
Foreign Body
- Urinary catheters
- Calculus
- Tumours obstructing normal urinary flow
Other Conditions
- Cystitis
- Urethritis
- Prostatitis
- Diabetes mellitus
- Immunocompromised states
- Sickle cell disease
- Transplantation
- Pregnancy
- HIV Infection
- Chemotherapy
General/Behavioral
- change in sexual partner within the last year
- spermicide use
- Decreased expression of CXCR1 (a receptor for IL-8)
- Genetic Predisposition
- Positive family history (close family members with frequent urination)
- Young women are most likely to be affected, traditionally reflecting sexual activity in that age group.
- Infants and the elderly are also at increased risk, reflecting anatomical abnormalities and hormonal status.[10]
References
- ↑ Hooton TM, Scholes D, Hughes JP, Winter C, Roberts PL, Stapleton AE; et al. (1996). "A prospective study of risk factors for symptomatic urinary tract infection in young women". N Engl J Med. 335 (7): 468–74. doi:10.1056/NEJM199608153350703. PMID 8672152.
- ↑ Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE (2005). "Risk factors associated with acute pyelonephritis in healthy women". Ann. Intern. Med. 142 (1): 20–7. PMID 15630106.
- ↑ Ramakrishnan K, Scheid DC (2005). "Diagnosis and management of acute pyelonephritis in adults". Am Fam Physician. 71 (5): 933–42. PMID 15768623.
- ↑ Bergeron MG (1995). "Treatment of pyelonephritis in adults". Med Clin North Am. 79 (3): 619–49. PMID 7752732.
- ↑ 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.
- ↑ Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE (2005). "Risk factors associated with acute pyelonephritis in healthy women". Ann Intern Med. 142 (1): 20–7. PMC 3722605. PMID 15630106.
- ↑ Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stamm WE (2000). "Risk factors for recurrent urinary tract infection in young women". J Infect Dis. 182 (4): 1177–82. doi:10.1086/315827. PMID 10979915.
- ↑ Scholes D, Hawn TR, Roberts PL, Li SS, Stapleton AE, Zhao LP; et al. (2010). "Family history and risk of recurrent cystitis and pyelonephritis in women". J Urol. 184 (2): 564–9. doi:10.1016/j.juro.2010.03.139. PMC 3665335. PMID 20639019.
- ↑ Lundstedt AC, Leijonhufvud I, Ragnarsdottir B, Karpman D, Andersson B, Svanborg C (2007). "Inherited susceptibility to acute pyelonephritis: a family study of urinary tract infection". J Infect Dis. 195 (8): 1227–34. doi:10.1086/512620. PMID 17357062.
- ↑ Czaja CA, Scholes D, Hooton TM, Stamm WE (2007). "Population-based epidemiologic analysis of acute pyelonephritis". Clin. Infect. Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303.