PYELONEPHRITIS, CHRONIC

(Kidney Infection, Chronic)

 Basic information

description

Chronic pyelonephritis is a disorder of the kidneys that develops slowly and lasts for months or years. Over time, the kidneys become scarred or damaged. They begin to lose their ability to function as they normally would in removing waste products from the blood. This disorder affects infants and young children more than it does adults. It is more common in females.

FREQUENT SIGNS & SYMPTOMS

• Usually there are no symptoms (unlike acute pyelonephritis). It may be diagnosed when medical tests are done for recurrent urinary tract infections.
• Symptoms that do occur may be vague, such as abdominal pain, fever, tiredness, nausea, and vomiting.
• Failure to thrive in infants or young children.

causes

It results from recurrent or persistent kidney (renal) infection and inflammation. It occurs mostly in people who have a urinary tract abnormality (different from the normal).

risk increases with

• Acute pyelonephritis.
• Vesicoureteral reflux or VUR (backward flow of urine) in children.
• Diabetes.
• Urinary obstruction, such as from renal stones, tumors, or enlarged prostate.

PREVENTIVE MEASURES

• There are no specific preventive measures.
• Controlling diabetes, getting treatment for urinary-tract infections, or surgery for a urinary tract abnormality can help reduce risks.

expected outcomes

• The outcome depends on the extent of kidney damage. Early diagnosis and treatment can help delay disease progress.
• VUR in children may in time resolve on its own.

possible complications

• Chronic kidney failure.
• End-stage renal disease (ESRD).
• Need for a kidney transplant or kidney dialysis.
• Hypertension (high blood pressure).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam. Medical tests include blood and urine studies and urine culture. Other tests may include x-ray, ultrasound, kidney scan, cystoscopy, or a urine voiding study.
• Treatment includes drugs or surgery. Follow your treatment plan carefully. This may not be easy for an illness that causes few symptoms in the early stages.
• Surgery may be needed to relieve obstruction or correct any structural problem in the urinary tract.

medications

• Antibiotics are usually prescribed. They are taken for months or years.
• Drugs may be prescribed to keep the urine slightly acidic.
• Drugs may be prescribed to lower blood pressure.

activity

Usually, no limits. You will be advised of any temporary limits if surgery is performed.

diet

• To help prevent urinary tract infections, drink plenty of fluids each day. Drinking cranberry juice may also help.
• A low-protein diet may be prescribed if kidney failure develops.

 notify our office if

• You or a family member has symptoms of chronic pyelonephritis.
• You or a family member has symptoms of an acute kidney infection, such as urgent, frequent, or burning urination; fever and chills; fatigue; and cloudy urine.

Special Notes: