Pyelonephritis is an infection and inflammation of the kidneys that is usually caused by bacteria ascending from the lower urinary tract. It is more common in females than males, especially between ages 15-35. Common symptoms include flank pain, fever, nausea, and urinary symptoms like dysuria and hematuria. Diagnosis involves urinalysis showing white blood cells and a urine culture. Treatment focuses on antibiotics and prevention emphasizes frequent urination and hydration to maintain bladder health.

1. Guided by
Dr.T.Venu
Pyelonephritis
Presented by
J. Vishnu
RT/2016/604

2. Contents
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 Introduction
 Epidemiology
 Etiology
 Pathophysiology
 Signs and symptoms
 Diagnosis
 Prevention
 Conclusion
 Reference

3. Introduction
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 Upper urinary tract Infections:
 Pyelonephritis
 Inflammation of renal pelvis and parenchyma (functional kidney tissue)
 Results from an infection that ascends to kidney from lower urinary tract

4. Epidemiology
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 Pyelonephritis is significantly more common in females than in
males
 15-17 cases per 10,000 females in a year
 3-4 cases per 10,000 males per year
 Acute pyelonephritis develops in 20-30% of pregnant women
 An estimated 50 % of women report having had a UTI at some
point in their lives.

5. Epidemiology
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 Pyelonephritis shows a trimodal distribution in females
 Elevated incidence in girls aged 0-4 years.
 A peak in women 15-35 years of age.
 Gradual increase after age 50 years.
 In males it shows bimodal distribution
 With an elevated incidence at 0-4 years of age
 It is gradually increase after 35 years of age

6. Etiology
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 Escherichia coli
 Almost 80% pyelonephritis cause by E-coli
 Staphylococcus saprophyticus
 Proteus mirabilis
 Klebsiella
 Enterococcus
 Kidney stones can also contribute to pyelonephritis
• Providing a place for bacteria to grow while evading the body's
defenses.
 People with diabetes or conditions that impair the immune system are
more likely to get pyelonephritis.

7. Pathophysiology
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 Acute pyelonephritis results from bacterial invasion of the renal
parenchyma.
 Bacteria usually reach the kidney by ascending from the lower
urinary tract In all age groups
 Bacteria may also reach the kidney via the bloodstream

8. Pathophysiology
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 Contamination of the periurethral area with a uropathogen from the gut
 Colonization of the urethra and migration to the bladder
 Colonization and invasion of the bladder mediated by pili and adhesion
 Inflammatory response in the bladder and fibrinogen accumulation in the
catheter
 Epithelial damage by bacterial toxins and proteases
 Ascension to the kidneys
 Colonization of the kidney
 Host tissue damage by the bacterial toxins

9. Pathophysiology
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11. What happens to the kidney?
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 The kidney becomes edematous and
inflamed and the blood vessel are
congested
 The urine may be cloudy and contain
pus, mucus and blood
 Small abscesses may form in the
kidney

12. Symptoms of Pyelonephritis
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 Flank pain
 Pyuria (pus in urine )
 Dysuria (painful discharge of urine )
 Hematuria ( blood in urine)
 Increased frequency urine
 Fever (usually present)
 Nausea/Vomiting

13. Diagnosis pyelonephritis
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 Physical Exam:
 CVA tenderness
 CT Scan
 Labs: Urinalysis
• WBCs
• RBCs
• Leukocyte esterase (Helps to screen for pyuria)
• Nitrites(More likely gram-negative rods)
• Urine culture

14. Prevention
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 Increase fluid intake to at least 6- 8 glasses per day to maintain
bladder hygiene.
 Personal hygiene
 Women should avoid prolonged sitting in wet clothes
 Do not postpone urination when feel the urge to urinate
 Empty your bladder completely when urinate

15. Conclusion
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 It is a most common disease for females of 15-35 year age group
 It is mainly caused by the bacterial infection
 Biggest bugs for Pyelonephritis are E. coli (80% )
 It is preventable disease

16. Reference
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 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based
epidemiologic analysis of acute pyelonephritis. Clin Infect Dis. 2007 , 273-
80.
 Ramakrishnan K, Scheid DC. Diagnosis and management of acute
pyelonephritis in adults. Am Fam Physician. 2005 ,933-42.
 Craig WD, Wagner BJ, Travis MD. Pyelonephritis: radiologic-pathologic
review. Radiographics.2008 ,255-77.
 Johnson PT, Horton KM, Fishman EK. Optimizing detectability of renal
pathology with MDCT: protocols, pearls, and pitfalls.2010;101-12.

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