Renal pelvic inflammation

In most cases, ascending bacteria from the urinary tract are to blame when the renal pelvis becomes inflamed. A sudden feeling of illness with fever and pain in the side of the back (flank pain) are typical of this inflammation.

Overview: What is pyelonephritis?

Pyelonephritis (from the Greek words nephros for kidney and pyelos for pelvis) is one of the most common kidney diseases. The renal pelvis is the cavity in the kidneys in which the urine produced by the kidney tissue collects before leaving the body via the ureter, bladder and urethra.

The kidney infection mainly affects women. Why they are particularly at risk is due to the anatomical differences between the male and female urinary tract. The urethra is much shorter in women than in men. This allows invading bacteria to reach the bladder particularly quickly. A bladder infection can possibly ascend into the renal pelvis via the ureter.

In contrast to cystitis, where the symptoms are localized, with pyelonephritis the entire body reacts with a pronounced feeling of illness.

Renal pelvic inflammatory disease: causes and risk factors

In the vast majority of cases, the cause of pyelonephritis is a bacterial, ascending infection. This means that bacteria have spread via the urethra and bladder to the renal pelvis.

In women, intestinal bacteria can relatively easily enter the urethra and cause cystitis or pyelonephritis.

Residual urine can be a risk factor for the development of urinary tract infections and therefore also for pyelonephritis. This residual urine provides the ideal conditions for germs to multiply.

In addition to residual urine formation, other risk factors such as metabolic diseases, for example diabetes, also play a role in the development of pyelonephritis. The risk of pyelonephritis can also be increased if a bladder catheter has to be worn permanently to drain urine.

Symptoms: Acute pyelonephritis is different from chronic pyelonephritis

Acute pyelonephritis is characterized by the following symptoms:

  • High fever and chills
  • Pronounced feeling of illness with fatigue
  • Severe back pain / flank pain on the side of the kidney inflammationIn some cases, blood may also be noticed in the urine

Renal pelvic inflammatory disease: Diagnosis with us

In the first step, we will ask you about your complaints, i.e. the symptoms. We will ask you whether you have recently or currently had a urinary tract infection. Other illnesses or known kidney or bladder stones are also asked about.

One of the most important examinations for suspected pyelonephritis: The doctor carefully taps the flanks. If flank pain occurs, this is an important indication of pyelonephritis.

Urine test and blood test for pyelonephritis

A urine test and a blood test also help. The result of a urine culture can be used to identify which pathogen is involved. The blood values provide information about how severe the inflammation is.

Ultrasound examination

Sonography, i.e. ultrasound examination, is an additional imaging procedure. This allows us to clarify whether there is a urinary blockage, which may be the cause of the inflammation. Possible triggers for urinary retention can also be identified with ultrasound, such as ureteral stones.

Renal pelvic inflammatory disease: prevention, early detection, prognosis

Up to a certain limit, every person can influence whether or not they get pyelonephritis, as there are specific preventive measures. The five most important tips are:

  1. Drink enough, at least two liters a day, so that the urinary tract is well flushed. This makes it difficult for germs to colonize and multiply.
  2. Make sure you maintain good intimate hygiene. This means not washing too much, but also not too little. Use pH-neutral washing syndets and the shower to wash away germs from the intimate area. Running water is therefore better than a washcloth, at least in this part of the body.
  3. Toilet hygiene is also important – always wipe from front to back after urinating and defecating.
  4. Avoid hypothermia of the abdomen and cold feet – this reduces blood circulation in the urinary tract. Reduced blood flow makes them vulnerable to germs and pathogens.
  5. Take urinary tract infections seriously and ask us whether antibiotics would be advisable. There are a number of alternatives that can be tried before using an antibiotic. The infection should be prevented from spreading to the kidney.

Course and prognosis of pyelonephritis

The chances of recovery from acute pyelonephritis are good. However, the prerequisite for this is that it is recognized and treated at an early stage. After around two weeks, the inflammation is healed again with the right therapy.

A serious complication is the risk of blood poisoning from the kidneys and urinary tract, known as urosepsis.

Clinical picture: Treatment of pyelonephritis

Thorough and sufficiently long treatment is important. Antibiotics are the treatment of choice for pyelonephritis.