Renal System Disorders: Pyelonephritis

Study Notes

Inflammation of the renal pelvis and functional units of the kidney (nephrons), involving the cortex and medulla (parenchyma of the kidney).
Higher incidence in women than men.
Two main types: acute and chronic pyelonephritis.

Sudden and severe infection of the kidney by Gram-negative bacteria (e.g., E. coli and Proteus mirabilis).
Signs and symptoms: • Sudden onset of fever • Chills • Nausea • Vomiting • Groin pain • Haematuria • Dysuria and rigor
Investigations: • Midstream specimen or catheter specimen of urine to identify causative organism • Full blood count to check for raised white blood cells • Intravenous pyelogram to identify urinary tract obstruction • Full nursing and medical history to identify previous urinary tract infection and kidney stones
Pharmacological interventions: • Analgesics for pain management • Antibiotics to treat the infection • Anti-emetics for nausea and vomiting • Antipyretics to treat pyrexia

Progression from acute pyelonephritis, affecting the calyces and renal pelvis of the kidney.
Can begin in childhood, leading to scarring and fibrosis of the kidney, and eventual renal failure.
Signs and symptoms: • Fever • Abdominal and groin pain • Hypertension • Dysuria • Proteinuria

Inflammation of the urinary bladder, which may hemorrhage.
Most common form of urinary tract infection, affecting women more than men.
Causes: • Bacterial infection • Sexual intercourse • Pregnancy • Rectal intercourse • Urinary tract obstruction (e.g., enlarged prostate gland) • Chemicals in washing powder • Nylon underwear • Stress
Signs and symptoms: • Dysuria • Pyuria • Haematuria • Abdominal discomfort • Nocturia • Urinary incontinence

Acute kidney injury (AKI): inability of kidneys to remove accumulated metabolites from the blood, leading to altered fluid, electrolyte, and acid-base balance.
Causes: primary kidney disorder, systemic disease, or other urological defects.
Chronic kidney disease (CKD): slow and insidious development, with few symptoms until severe kidney damage.