Pyelonephritis is a bacterial infection of the kidney, usually spreading upward from the bladder. It needs prompt treatment to prevent complications such as kidney damage or bloodstream infection. Dr. Satarupa Deb diagnoses and treats kidney infections at Bombay Hospital, South Mumbai.
What Is Pyelonephritis?
Most urinary tract infections (UTIs) stay in the bladder. When bacteria travel up the ureters to one or both kidneys, the infection is called pyelonephritis. It is a more serious infection than a simple bladder infection.
With timely antibiotics, most people recover fully. Repeated or complicated infections, however, may cause scarring of the kidney, so it is important to find any underlying cause.
Causes and Risk Factors
Bacteria from the bowel, most commonly E. coli, are the usual cause. The risk may be higher in:
- Women, due to a shorter urethra
- Pregnancy
- Diabetes, especially when sugar control is poor
- Kidney stones or other blockage of urine flow
- An enlarged prostate in men
- Urinary catheters, recent urinary procedures or a weakened immune system
- Structural problems of the urinary tract, such as reflux of urine
Symptoms
Symptoms often develop quickly over a day or two and may include:
- High fever with chills and shivering
- Pain in the back, side or groin
- Burning or pain while passing urine and frequent urge to urinate
- Cloudy, foul-smelling or blood-stained urine
- Nausea, vomiting and feeling very unwell
- Confusion in older adults, which may be the only sign
Diagnosis
Your doctor will examine you and order tests to confirm the infection, identify the bacteria and check for complications.
- Urine routine examination and urine culture before starting antibiotics where possible
- Blood counts, creatinine and blood culture in more severe cases
- Ultrasound of the kidneys to look for blockage, stones or abscess
- CT scan when symptoms do not improve or a complicated infection is suspected
Treatment of Kidney Infection
Antibiotics are the main treatment. Mild cases may be treated with oral antibiotics at home, while people who are very unwell, pregnant, unable to keep fluids down or have complications may need hospital admission and intravenous antibiotics. The choice is adjusted once culture results are available, which is important given rising antibiotic resistance.
Adequate fluids, fever and pain relief (avoiding kidney-harmful painkillers), and good blood sugar control are also important. Any blockage, such as a stone, may need to be relieved. Complete the full course of antibiotics even if you feel better.
After treatment, your doctor may repeat urine tests to make sure the infection has cleared. In men, children, and anyone with repeated kidney infections, further imaging may be advised to look for stones, blockage or structural problems that make infections more likely. Correcting these can reduce the chance of future episodes.
When to See a Nephrologist
Seek urgent medical care for fever with back pain and urinary symptoms. A nephrologist review is helpful for recurrent kidney infections, infections in people with diabetes or chronic kidney disease, infections with rising creatinine, or those that do not respond to treatment.
Frequently Asked Questions
How is a kidney infection different from a normal UTI?
A bladder infection usually causes burning and frequent urination without high fever. A kidney infection typically adds fever, chills and back or side pain, and needs more urgent treatment.
Can a kidney infection damage my kidneys permanently?
Most infections treated promptly heal without lasting damage. Repeated, untreated or complicated infections may lead to scarring and reduced kidney function over time.
Why is a urine culture important?
A culture identifies the exact bacteria and which antibiotics will work. This helps your doctor choose the right treatment, particularly as antibiotic resistance is increasingly common.
How can I prevent kidney infections?
Drink enough water, do not hold urine for long periods, keep diabetes well controlled and seek early treatment for bladder infections. Recurrent infections should be evaluated for an underlying cause.
Consult Dr. Satarupa Deb
If you have recurrent or severe kidney infections, book a consultation with Dr. Satarupa Deb at Bombay Hospital, South Mumbai, for thorough evaluation and treatment.
This page is for general information only and is not a substitute for a medical consultation. Please consult a qualified doctor for diagnosis and treatment.