Pyelonephritis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pyelonephritis is serious condition requiring emergent medical management. Most individuals who are treated adequately with antibiotics do not undergo complications. A surgical management with removal of stone or obstructing tumour may sometimes be require dot prevent complications and prevent obstructive pyelonephritis and stop the course of chronic pyelonephritis. The most common complication of pyelonephritis is recurrent infections.[1][2]

Natural History

Complications

Pyelonephritis can lead to the following complications:[3][4]

  • Renal scaring[5]
  • Dilation of renal pelvis
  • Renal Atrophy[5]
  • Sub actute-chronic interstitial nephritis[5]
  • In rare cases, pyelonephritis may cause permanent kidney scars, which can lead to chronic kidney disease, high blood pressure, and kidney failure. These problems usually occur in people with a structural problem in the urinary tract, kidney disease from other causes, or repeated episodes of pyelonephritis.
  • Bacteremia or Bacteriuria [6]
  • sepsis, spread of the infection in the kidneys to the bloodstream
  • Septic metastasis to bones and endocardium[7]
  • Renal abscess[8][9][10]
  • Perinephric abscess is made by cortical staphylococcal renal abscess (Graves RC, Parkins LE. Carbuncle of the kidney. J Urol (Baltimore) 1970; 104:179.) or by rupturing of a renal abscess (Hill GS. Renal infection. In: Uropathology, 1st Ed, Hill GS (Ed), Churchill Livingstone, New York 1989; 33.)[8]
  • Iliopsoas abscess [12]
  • Peritoneal abscess[13]

Prognosis

Prognosis: 20121956

References

  1. 1.0 1.1 Hoverman IV, Gentry LO, Jones DW, Guerriero WG (1980). "Intrarenal abscess. Report of 14 cases". Arch Intern Med. 140 (7): 914–6. PMID 6992728.
  2. Kofteridis DP, Papadimitraki E, Mantadakis E, Maraki S, Papadakis JA, Tzifa G; et al. (2009). "Effect of diabetes mellitus on the clinical and microbiological features of hospitalized elderly patients with acute pyelonephritis". J Am Geriatr Soc. 57 (11): 2125–8. doi:10.1111/j.1532-5415.2009.02550.x. PMID 20121956.
  3. Anderson KA, McAninch JW (1980). "Renal abscesses: classification and review of 40 cases". Urology. 16 (4): 333–8. PMID 7414775.
  4. Fowler JE, Perkins T (1994). "Presentation, diagnosis and treatment of renal abscesses: 1972-1988". J Urol. 151 (4): 847–51. PMID 8126807.
  5. 5.0 5.1 5.2 Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P; et al. (1989). "Frequency of development of early cortical scarring in acute primary pyelonephritis". Kidney Int. 35 (2): 696–703. PMID 2651759.
  6. Lee BK, Crossley K, Gerding DN (1978). "The association between Staphylococcus aureus bacteremia and bacteriuria". Am J Med. 65 (2): 303–6. PMID 686015.
  7. Siroky MB, Moylan R, Austen G, Olsson CA (1976). "Metastatic infection secondary to genitourinary tract sepsis". Am J Med. 61 (3): 351–60. PMID 986763.
  8. 8.0 8.1 Dembry LM, Andriole VT (1997). "Renal and perirenal abscesses". Infect Dis Clin North Am. 11 (3): 663–80. PMID 9378929.
  9. Fair WR, Higgins MH (1970). "Renal abscess". J Urol. 104 (1): 179–83. PMID 4913271.
  10. Yen DH, Hu SC, Tsai J, Kao WF, Chern CH, Wang LM; et al. (1999). "Renal abscess: early diagnosis and treatment". Am J Emerg Med. 17 (2): 192–7. PMID 10102326.
  11. Saiki J, Vaziri ND, Barton C (1982). "Perinephric and intranephric abscesses: a review of the literature". West J Med. 136 (2): 95–102. PMC 1273539. PMID 7039139.
  12. Kawamoto A, Sato R, Takahashi K, Luthe SK (2016). "Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-218541. PMID 27974344.
  13. Yeow Y, Chong YL (2016). "Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess". J Surg Case Rep. 2016 (12). doi:10.1093/jscr/rjw211. PMC 5159021. PMID 27915241.

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