DOCSLIB.ORG

Pyelonephritis (Kidney Infection)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pyelonephritis (Kidney Infection) Pyelonephritis (Kidney Infection) Cathy E. Langston, DVM, DACVIM (Small Animal) BASIC INFORMATION urine collected from the bladder to be negative despite infection in the Description kidney. Abdominal x-rays and an ultrasound may be recommended. Bacterial infection of the kidney is termed pyelonephritis . Infection Although culture of a piece of kidney tissue obtained by biopsy may occur within kidney tissue or in the renal pelvis, the area of increases the chance of finding the infection, the invasiveness of the kidney where urine collects before being transported to the the procedure makes it too risky for general use (the biopsy would bladder. need to be taken from deeper within the kidney than the average Causes kidney biopsy). Contrast x-ray studies, such as an excretory uro- In most cases, a urinary tract infection starts in the bladder and gram (intravenous pyelogram), are sometimes helpful. An excre- the bacteria travel upstream to the kidney. Anything that decreases tory urogram involves taking a series of x-rays after a dye (that the free flow of urine, such as obstruction of the urethra (tube shows up white on x-rays) is given intravenously. Other tests may that carries urine from the bladder to the outside), bladder, ureter be recommended to rule out diseases that cause similar clinical (tube that carries urine from the kidney to the bladder), or kid- signs and other causes of kidney disease. ney, increases the risk that the infection will spread to the kid- ney. The presence of stones and growths in the bladder and kidney TREATMENT AND FOLLOW-UP also increases the risk. Other contributing factors include chronic kidney disease, diabetes mellitus, and conditions that impair the Treatment Options immune system or cause dilute (watery) urine. Antibiotics are the mainstay of treatment of bacterial pyelonephritis The most common bacterial infection in the kidney is with and are often chosen based on a urine culture. If the urine culture is Escherichia coli . Other bacteria may also be involved, and fungal negative, a good antibiotic choice is one that is effective against infections occur rarely. E. coli . Kidney infections take much longer to cure than simple blad- der infections, so antibiotics are usually continued for 4-6 weeks. If Clinical Signs infection is related to a complete or partial blockage, removal of the If only one kidney is infected, no clinical signs may be noted, obstruction may be necessary to achieve resolution of the infection. and blood and urine tests may also be normal. If both kidneys are infected, signs may be those of kidney failure, such as increased Follow-up Care volume of urine, increased thirst, poor appetite, vomiting, nausea, With acute infections that cause complete kidney shutdown, and lethargy. Signs of a bladder infection, such as frequent urina- improvement in kidney function may be seen within 4-7 days of tion of small volumes of urine, pain on urination, and straining, starting antibiotics. With chronic kidney infections, no improve- may also be present. Blood in the urine can arise with infection in ment in kidney function may occur, but decreasing the amount of the kidneys or the bladder. ongoing damage in the kidney is still beneficial. If the infection causes acute kidney failure, decreased or no Repeating a urine culture 5-7 days after starting antibiotics is urine production may occur, and the kidneys may become pain- sometimes recommended to make sure the infection is resolving. ful and swollen. Fever and a high white blood cell count may be Culture is often recommended about a week after completing the present, but the absence of either of these does not exclude kid- antibiotics, and again a month later. Blood tests for kidney function ney infection. With chronic kidney infections, clinical signs may are usually performed at the same time. The need for repeated abdom- be minimal or absent. Chronic infection causes damage to the inal ultrasounds to monitor the course of the disease is variable. kidney; however, that results in scar tissue and shrinkage of the Prognosis kidneys. Kidney infections can be serious, life-threatening conditions, but of all the causes of complete, acute kidney shutdown, they are one of the Diagnostic Tests most treatable. About 75% of affected animals recover from an acute Initial diagnostic tests typically include blood tests to evaluate kidney infection. The success rate for chronic infections is much lower. The function and urine tests to evaluate urine concentrating ability. rate of progression of kidney failure with chronic infections is vari- A urine culture is performed, but it is not uncommon for culture of able; however, many animals can live for years after an infection. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved..
Load more

Recommended publications
  • Acute Kidney Injury: Challenges and Opportunities
    Acute kidney injury: Challenges and opportunities Abstract: Community-acquired acute kidney injury (CA-AKI) can be a devastating diagnosis for any patient and can increase mortality during hospitalization. There can be long-term consequences for those who survive the initial insult. This article discusses CA-AKI and its implications for APRNs. By Nhan L.A. Dinh, MSN, CNP, AGACNP-BC, CCRN cute kidney injury (AKI) is a heterogeneous risk of CKD, but if clinicians do not recognize the kidney disorder that increases in-hospital diagnosis, they cannot follow up or intervene. An AKI A morbidity and mortality. In 2016 data, the diagnosis also increases the chance of another AKI incidence of AKI was 20% for Medicare patients with episode, with a 30% risk of a recurrent AKI episode both chronic kidney disease (CKD) and diabetes.1 Us- within 1 year.1 ing Veterans Affairs (VA) 2016 data, AKI occurred in Mortality is increased with an AKI episode. Medi- more than 25% of hospitalized veterans over age 22, care data from 2016 shows an in-hospital mortality of but less than 50% of those with lab-documented AKI 8.2% but this increases to over 13% when includ- were coded as such.1 The chief concern here is a missed ing patients who were discharged to hospice.1 The in- opportunity for intervention. AKI increases long-term hospital mortality for patients without AKI was only Keywords: acute kidney injury (AKI), Acute Kidney Injury Network (AKIN), chronic kidney disease (CKD), community-acquired acute kidney injury (CA-AKI), hospital-acquired acute kidney injury (HA-AKI), Kidney Disease Improving Global Outcomes (KDIGO), SvetaZi / Shutterstock Nephrotoxic Injury Negated by Just-in-time Action (NINJA), sick day rules 48 The Nurse Practitioner • Vol.
    [Show full text]
  • Impact of Urolithiasis and Hydronephrosis on Acute Kidney Injury in Patients with Urinary Tract Infection
    bioRxiv preprint doi: https://doi.org/10.1101/2020.07.13.200337; this version posted July 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. Impact of urolithiasis and hydronephrosis on acute kidney injury in patients with urinary tract infection Short title: Impact of urolithiasis and hydronephrosis on AKI in UTI Chih-Yen Hsiao1,2, Tsung-Hsien Chen1, Yi-Chien Lee3,4, Ming-Cheng Wang5,* 1Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan 2Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan 3Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan 4School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan 5Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan *[email protected] 1 bioRxiv preprint doi: https://doi.org/10.1101/2020.07.13.200337; this version posted July 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. Abstract Background: Urolithiasis is a common cause of urinary tract obstruction and urinary tract infection (UTI). This study aimed to identify whether urolithiasis with or without hydronephrosis has an impact on acute kidney injury (AKI) in patients with UTI.
    [Show full text]
  • Hypertensive Kidney Disease Hypertensive Kidney
    JAMA PATIENT PAGE The Journal of the American Medical Association KIDNEY DISEASE Hypertensive Kidney Disease ypertension (high blood pressure) causes problems for many organs in the body, including the kidneys. Kidney problems Hcaused by high blood pressure (hypertensive kidney disease) occur often in persons who have undetected, untreated, or poorly controlled hypertension. Kidney problems are also called renal dysfunction or renal failure. Certain groups of people, including African Americans and Native Americans, are more at risk for having hypertensive kidney disease. High blood pressure is the second leading cause of kidney failure, surpassed only by diabetes. African Americans are 6 times more likely than whites to have chronic renal failure related to high blood pressure. The November 20, 2002, issue of JAMA includes an article about high blood pressure and its effect on the kidneys. WHY IS HIGH BLOOD PRESSURE DANGEROUS? FOR MORE INFORMATION High blood pressure makes the heart work harder and can also damage the small blood • American Heart Association vessels in the body. These vessels are in all organs of the body, including the kidneys, the 800/242-8721 heart, and the brain. Damage to the arteries (blood vessels that carry blood to organs) www.americanheart.org results in insufficient blood flow to those organs and organ damage. In the kidney, this • National Institute of Diabetes & organ damage is called nephrosclerosis. The kidneys lose their ability to filter blood, Digestive & Kidney Diseases allowing buildup of substances that can be toxic to the body. Eventually the kidneys fail, www.niddk.nih.gov/health/kidney and dialysis (filtration of blood by a special machine) or a kidney transplant becomes /pubs/highblood/highblood.htm necessary to preserve the person’s life.
    [Show full text]
  • Uremic Toxins Affect Erythropoiesis During the Course of Chronic
    cells Review Uremic Toxins Affect Erythropoiesis during the Course of Chronic Kidney Disease: A Review Eya Hamza 1, Laurent Metzinger 1,* and Valérie Metzinger-Le Meuth 1,2 1 HEMATIM UR 4666, C.U.R.S, Université de Picardie Jules Verne, CEDEX 1, 80025 Amiens, France; [email protected] (E.H.); [email protected] (V.M.-L.M.) 2 INSERM UMRS 1148, Laboratory for Vascular Translational Science (LVTS), UFR SMBH, Université Sorbonne Paris Nord, CEDEX, 93017 Bobigny, France * Correspondence: [email protected]; Tel.: +33-2282-5356 Received: 17 July 2020; Accepted: 4 September 2020; Published: 6 September 2020 Abstract: Chronic kidney disease (CKD) is a global health problem characterized by progressive kidney failure due to uremic toxicity and the complications that arise from it. Anemia consecutive to CKD is one of its most common complications affecting nearly all patients with end-stage renal disease. Anemia is a potential cause of cardiovascular disease, faster deterioration of renal failure and mortality. Erythropoietin (produced by the kidney) and iron (provided from recycled senescent red cells) deficiencies are the main reasons that contribute to CKD-associated anemia. Indeed, accumulation of uremic toxins in blood impairs erythropoietin synthesis, compromising the growth and differentiation of red blood cells in the bone marrow, leading to a subsequent impairment of erythropoiesis. In this review, we mainly focus on the most representative uremic toxins and their effects on the molecular mechanisms underlying anemia of CKD that have been studied so far. Understanding molecular mechanisms leading to anemia due to uremic toxins could lead to the development of new treatments that will specifically target the pathophysiologic processes of anemia consecutive to CKD, such as the newly marketed erythropoiesis-stimulating agents.
    [Show full text]
  • Glomerulonephritis Management in General Practice
    Renal disease • THEME Glomerulonephritis Management in general practice Nicole M Isbel MBBS, FRACP, is Consultant Nephrologist, Princess Alexandra lomerular disease remains an important cause Hospital, Brisbane, BACKGROUND Glomerulonephritis (GN) is an G and Senior Lecturer in important cause of both acute and chronic kidney of renal impairment (and is the commonest cause Medicine, University disease, however the diagnosis can be difficult of end stage kidney disease [ESKD] in Australia).1 of Queensland. nikky_ due to the variability of presenting features. Early diagnosis is essential as intervention can make [email protected] a significant impact on improving patient outcomes. OBJECTIVE This article aims to develop However, presentation can be variable – from indolent a structured approach to the investigation of patients with markers of kidney disease, and and asymptomatic to explosive with rapid loss of kidney promote the recognition of patients who need function. Pathology may be localised to the kidney or further assessment. Consideration is given to the part of a systemic illness. Therefore diagnosis involves importance of general measures required in the a systematic approach using a combination of clinical care of patients with GN. features, directed laboratory and radiological testing, DISCUSSION Glomerulonephritis is not an and in many (but not all) cases, a kidney biopsy to everyday presentation, however recognition establish the histological diagnosis. Management of and appropriate management is important to glomerulonephritis (GN) involves specific therapies prevent loss of kidney function. Disease specific directed at the underlying, often immunological cause treatment of GN may require specialist care, of the disease and more general strategies aimed at however much of the management involves delaying progression of kidney impairment.
    [Show full text]
  • UTI and Pyelonephritis Summary
    CHI Franciscan Health UTI & Pyelonephritis Summary UTI/pyelonephritis is one of the most common infectious processes but is also often over-treated. Inappropriate treatment rates vary between 17-26%1,2 and up to 52% in patients with indwelling urinary catheters3. Overtreatment can result in unnecessary medication side effects, the development of Clostridium difficile resistance4, colonization with drug-resistant organisms, and undue costs to the health system. Pharmacists can play and important role in optimizing drug therapy to include the recommendation to stop inappropriate antibiotics when their use is not indicated. Asymptomatic bacteriuria (ASB): the presence of bacteria in the urine without signs/symptoms of infection5 o McGeer Criteria often used to define infection, particularly in the long-term care setting6 Clinical (at least one of the following) Lab (at least one of the following) □ Acute dysuria □ Voided specimen: positive urine culture □ Acute pain, swelling, or tenderness of testes, (> 105 CFU/mL), no more than 2 epididymis, or prostate organisms □ Fever or leukocytosis with one of the following: □ Straight cath specimen: positive urine ○ Acute CVA pain or tenderness culture (> 105 CFU/mL), any number of ○ Suprapubic pain organisms ○ Gross hematuria ○ New or marked increase in incontinence ○ New or marked increase in urgency ○ New or marked increase in frequency □ Two of the preceding symptoms in the absence of fever or leukocytosis o ASB should only be treated in pregnant women and patients undergoing invasive urologic procedures5 o People with ASB also often have WBC in the urine (pyuria) but, in the absence of symptoms, this is not indicative of infection o Caused by: colonization of the bladder or contamination of the sample .
    [Show full text]
  • Urinalysis and Kidney Disease: What You Need to Know
    URINALYSIS AND KIDNEY DISEASE What You Need To Know www.kidney.org About the Information in this Booklet Did you know that the National Kidney Foundation (NKF) offers guidelines and commentaries that help your healthcare provider make decisions about your medical treatment? The information in this booklet is based on those recommended guidelines. Stages of Kidney Disease There are five stages of kidney disease. They are shown in the table below. Your healthcare provider determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your kidney function. Your treatment is based on your stage of kidney disease. Speak to your healthcare provider if you have any questions about your stage of kidney disease or your treatment. STAGES OF KIDNEY DISEASE Glomerular Stage Description Filtration Rate (GFR)* Kidney damage (e.g., protein 1 90 or above in the urine) with normal GFR Kidney damage with mild 2 60 to 89 decrease in GFR 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 *Your GFR number tells your healthcare provider how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases. What is a urinalysis (also called a “urine test”)? A urinalysis is a simple test that looks at a small sample of your urine. It can help find conditions that may need treatment, including infections or kidney problems. It can also help find serious diseases in the early stages, like chronic kidney disease, diabetes, or liver disease.
    [Show full text]
  • Urinary Tract Infections
    Urinary Tract Infections www.kidney.org Did you know that... n Urinary tract infections (UTIs) are responsible for nearly 10 million doctor visits each year. n One in five women will have at least one UTI in her lifetime. Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another. Of this last group, 80 percent will have recurrences. n About 80 to 90 percent of UTIs are caused by a single type of bacteria. 2 NATIONAL KIDNEY FOUNDATION n UTIs can be treated effectively with medications called antibiotics. n People who get repeated UTIs may need additional tests to check for other health problems. n UTIs also may be called cystitis or a bladder infection. This brochure answers the questions most often asked about UTIs. If you have more questions, speak to your doctor. What is a urinary tract infection? A urinary tract infection is what happens when bacteria (germs) get into the urinary tract (the bladder) and multiply. The result is redness, swelling and pain in the urinary tract (see diagram). WWW.KIDNEY.ORG 3 Most UTIs stay in the bladder, the pouch-shaped organ where urine is stored before it passes out of the body. If a UTI is not treated promptly, the bacteria can travel up to the kidneys and cause a more serious type of infection, called pyelonephritis (pronounced pie-low-nef-right- iss). Pyelonephritis is an actual infection of the kidney, where urine is produced. This may result in fever and back pain. What causes a UTI? About 80 to 90 percent of UTIs are caused by a type of bacteria, called E.
    [Show full text]
  • High Blood Pressure and Chronic Kidney Disease: for People
    HIGH BLOOD PRESSURE AND CHRONIC KIDNEY DISEASE For People with CKD Stages 1–4 www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™) has guidelines and commentaries that help your doctor and healthcare team make important decisions about your medical treatment? The information in this booklet is based on the NKF- KDOQI recommended guidelines and commentaries. What is your stage of kidney disease? There are five stages of kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment. STAGES of KidNEY DISEASE AGES of KidNEY DISEASE STAGES OF KIDNEY DISEASE Stage Description Glomerular Filtration Rate (GFR)* Kidney damage (e.g., protein 1 90 or above in the urine) with normal GFR Kidney damage with mild 2 60 to 89 decrease in GFR 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 *Your GFR number tells your doctor how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases. 2 NATIONAL KIDNEY FOUNDATION TABLE of ConTEntS Did you know? ...............................4 What is chronic kidney disease? ................5 What is high blood pressure? ...................6 How are high blood pressure and kidney disease related? ..............................6 How do I know if my blood pressure is too high? ..................................7 How is blood pressure measured? How often should it be checked? ...............8 I have high blood pressure but am not sure if I have CKD.
    [Show full text]
  • What Is Lupus Nephritis
    What is lupus nephritis (LN)? Lupus nephritis (LN) is inflammation of the kidney that occurs as a common symptom of systemic lupus erythematosus (SLE), also known as lupus. Proteins in the immune system called antibodies damage important structures in the kidney. ⅱ Why are the kidneys important? To understand how lupus nephritis damages the kidney, it is important to understand how the kidneys work. The kidneys’ main function is to filter out excess waste and water from the blood through the urine. Kidneys also balance the salts and minerals circulating in the blood, help control blood pressure and make red blood cells. So, when the kidneys are damaged or fail, they can’t do their job as well. As a result, the kidneys are not able to filter out waste and water into the urine causing it to stay in the blood. What are the signs and symptoms of LN? Signs to ask the doctor about include blood in the urine or foamy urine which can mean that there is excess protein. Other signs to notice are swelling of legs, ankles, hands or tissue around the eyes as well as weight gain that can be caused by fluid the body isn’t getting rid of. ⅲ Symptoms of lupus nephritis also include high blood pressure, joint/muscle pain, high levels of waste (creatinine) in the blood, or impaired/failing kidney. ⅳ How common is LN? Lupus nephritis is the most common complication of lupus. Five out of 10 adults with lupus will have lupus nephritis, while eight out of 10 children with lupus will have kidney damage, which usually stems from lupus nephritis.
    [Show full text]
  • Pyonephrosis in Paraplegia
    PAPERS READ AT THE 1969 SCIENTIFIC MEETING 121 PYONEPHROSIS IN PARAPLEGIA By J. J. WALSH, M.D., F.R.C.S., M.R.C.P. THIS paper is a report on 32 cases of pyonephrosis treated personally and occurring as a complication of paraplegia or tetraplegia over a period of 17 years from 1950 to 1967. Seven further cases treated by colleagues during that time are not in­ cluded, so that the incidence would appear to be 39, in a total number of admissions of 3,4580r approximately I per cent. My reason for excluding the 7 cases was that time and circumstance did not allow correlation of information. The criterion for inclusion was the finding of frank pus under tension in the pelvis and calyces of one kidney due to ureteric obstruction. There was no case of simultaneous bilateral pyonephrosis due to this cause. Post-morten findings showing pus in both kidneys as a terminal event in fatal pyelonephritis were not included. Cases showing clear or cloudy urine under tension due to ureteric obstruction were also excluded. It was interesting that a few of the latter cases had longer probable periods of obstruction than one or two of the acceptable pyonephrosis, but had not in fact formed pus. Material. In all there were 32 cases of pyonephrosis 27 male and 5 female. Compared with an admission rate of approximately 23 per cent. of females this would appear to indicate a lower incidence in females but the numbers involved are I feel too small to be significant (Table I). TABLE I Material ! I Average time after onset Average probable period I of obstruction Average age I of spinal lesion 1 (years) (years) (2 excluded) I (days) i I Males 27 1 52.2 9"4 11·6 Females 5 29.2 4.8 7 i Total 32 1 38.8 8·7 II The age ranged from 19 to 65 the average being 38.8 years.
    [Show full text]
  • Focal Segmental Glomerulosclerosis
    some = Focal sections of = Segmental Focal Segmental kidney filters = Glomerulo FSGS Glomerulosclerosis = { are scarred Sclerosis How can research help? Research, which often requires patient participation, can lead to a better understanding of the causes, provide better diagnoses and more effective treatments, and ultimately help to find a cure. Be part of the discovery: By studying patients, researchers can more quickly unlock the mysteries of this disease. To get involved in research and stay informed, go to: Nephrotic Syndrome Study Network www.Nephrotic-Syndrome- NEPTUNE is a part of the NIH Rare Diseases Clinical Research Network (RDCRN). Funding and/or programmatic support for this project has been provided by U54 Studies.org DK083912 from the NIDDK and the NIH Office of Rare Diseases Research (ORDR), the NephCure Foundation and the University of Michigan. The views expressed in written materials of publications do not necessarily reflect the official policies of the or call 1-866-NephCure Department of Health and Human Services; nor does mention by trade names, commercial practices or organizations imply endorsement by the U.S. Government. What is Focal and Segmental Glomerulosclerosis? Symptoms, Diagnosis and Treatment Each person has Focal Segmental Glomerulosclerosis (FSGS) is a Your nephrologist may also recommend: two kidneys in rare disease that attacks the kidney’s filtering system • Diuretics and low salt diet help to control edema their lower back. (glomeruli) causing scarring of the filter. FSGS • A medication that blocks a hormone system called is one of the causes of a condition known as the renin angiotensin system (ACE inhibitor or ARB) Nephrotic Syndrome (NS).
    [Show full text]