Pyelonephritis (pyelonephritis)

21 October 2017

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Fever, fatigue, severe flank pain - with a kidney infection sufferers suddenly feel really sick. The disease is usually acute, if untreated but become chronic.

What is a kidney infection (pyelonephritis)?

The pyelonephritis - also known as pyelonephritis (Greek .: nephros = kidney, pyelos = pool) - is a kidney disease. The renal pelvis is inflamed acute or chronic in the area of ​​the ureter. Usually only one kidney is affected.

The pyelonephritis is one of the most common diseases of the kidney. Women are affected about twice as often as men. The reason for this: Women have a shorter urethra. So bacteria can easily get into the bladder and then ascending through the ureter into the renal pelvis.

However, men can get with age often pyelonephritis. The reason is usually an enlarged prostate that obstructs urine flow. After urination, then there remains a certain amount of urine in the bladder. This so-called residual urine has germs good growth opportunities and may be the origin of a pyelonephritis.

You can find more information on kidney disease and possible:

A typical signs of acute pyelonephritis is a sudden, severe malaise. Added the following symptoms:

But not with any acute pyelonephritis symptoms appear suddenly and correspond to the typical clinical picture: In some cases, the disease begins slow and calls atypical symptoms out. So acute pyelonephritis may for example be accompanied by:

Besides, the acute form of pyelonephritis Gastrointestinal symptoms such as mild nausea and vomiting, abdominal pain or signs of incomplete intestinal obstruction (so-called. Subileus) cause.

The kidney function is characterized by an acute pyelonephritis Not limited.

The chronic pyelonephritis can long time without symptoms run. Fever and other signs that are typical in the acute form, missing at the beginning altogether.

After some time impaired chronic pyelonephritis, however, kidney function, which can lead to renal failure in extreme cases.

Possible symptoms occur intermittently, and may also occur in many other diseases:

Since the kidney is involved, inter alia, on the formation of blood, chronic pyelonephritis can cause symptoms of anemia (anemia) with itself. a hazy reddish-colored urine, and also are typical (in about three to five times out of ten) and high blood pressure due to reduced fluid excretion. In addition, the kidney can no longer give as good at a chronic inflammation of the renal pelvis metabolic end products.

Chronic pyelonephritis may in particular cases special form occur by particularly severe symptoms characterized: as so-called xanthogranulomatous pyelonephritis. Typically, the inflamed kidney tissue is yellow and can nodular structure (granuloma) which. It can cause bleeding and tissue decay, as well as changes that look in imaging tests like a kidney tumor.

The xanthogranulomatous pyelonephritis caused common symptoms, which are more typical of an acute than for chronic pyelonephritis. This includes:

Since bacteria are often the cause pyelonephritis, is gewöhnlilch with antibiotics treated. These must be taken for seven to ten days:

to identify the causative agent of pyelonephritis in order to select the appropriate medication is important. Therefore, the doctor nor creates a urine culture prior to treatment from a urine sample. Is the causative agent determines the treatment is, if necessary, adjusted accordingly.

The chronic pyelonephritis must at every infectious thrust be treated with antibiotics in tablet form. If it remains still exist, even this form using infusions must be treated in hospital (inpatient).

In the xanthogranulomatous pyelonephritis also come first antibiotics used to control the inflammation. pyelonephritis is then at this rare form an surgery necessary. Here, the affected kidney (depending on the infestation) so-called partially or completely removed (. nephrectomy).

A few weeks after the treatment, it is useful to have a more Urine culture for control purposes to apply. Is additionally a urinary obstruction before, the cause must be eliminated to prevent further pyelonephritis.

In children with chronic pyelonephritis especially urinary reflux is treated. Then the children get over a longer period antibiotics.

often lead urination disorders to a kidney infection. In some people, the urine flows from poor example, because of a urinary calculus. this favors ascending infections. The pathogens enter through the urethra into the bladder and hike from there through the ureter into the renal pelvis and further into the calices. Since the renal pelvis collect the urine formed in the kidney, created here easy infection.

In rare cases, the pathogens reach via the bloodstream to the renal pelvis.

There are different pathogens, the are eligible for a kidney infection. Most are bacteria responsible, most commonly the (intestinal) bacteria Escherichia coli. Other bacteria that can cause pyelonephritis are:

In addition, bacteria can in rare cases fungi be responsible for pyelonephritis. This can happen for example, if one becomes infected in the hospital (e.g., via a catheter).

In cases of suspected pyelonephritis diagnosis is as follows:

Imaging techniques can support the diagnosis:

The cause of chronic pyelonephritis in children determine, a X-ray examination with contrast medium are used. In this so-called Miktionszystourographie the doctor brings the contrast agent gently with a bladder catheter into the bladder of the child. This makes it possible,

A kidney infection can pass both acute and chronic.

The acute pyelonephritis often runs uncomplicated and heals with targeted and consistent antibiotic therapy usually consequences out. Even if the inflammation occurs repeatedly, they rarely turns into a chronic pyelonephritis.

The chronic pyelonephritis heals usually Not completely. It requires regular specialist medical checks and importance of antibiotic therapy of inflammatory episodes. Despite the persistent progression of chronic pyelonephritis rarely leads to progressive kidney failure.

A kidney infection can cause different complications:

An acute pyelonephritis may particularly be associated with complications if the infection took place during a hospital stay. The treatment is then more difficult because often many different pathogens are involved.

Under certain circumstances, also increases the risk that evolved from acute chronic pyelonephritis, for example:

A Pyelonephritis extends during pregnancy Although often normal (every second case remains undetected), yet the pyelonephritis may cause disorders of pregnancy to miscarriage and preterm birth.

If a chronic pyelonephritis impaired kidney function that can lead to high blood pressure and electrolyte imbalance. A progressive kidney failure as a result of pyelonephritis is rare (1 in 1,000 cases).

To prevent a kidney infection, is especially important one: plentiful and regularly drink!

If you already have an acute pyelonephritis, there is a risk that it turns into a chronic form. To prevent this, you have an acute pyelonephritis always fully heal.

If you have more than three or four urinary tract infections a year, the doctor will consult with you if any one Long term prophylaxis is recommended with antibiotics: Here take (first six months) daily antibiotics - in a lower dosage than in the treatment of an existing infection. Then stop taking the antibiotics and check under medical supervision if you are still prone to pyelonephritis.

In some women, there is a connection between sexual intercourse and the recurrence of pyelonephritis. If this is the case for you, so if you often about eight to ten hours after sex again notice signs of pyelonephritis, you may, after consultation with the doctor, instead of the long-term prophylaxis immediately before or after intercourse a low dose antibiotic taking.


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