小结
定义
病史和体格检查
关键诊断因素
- history of vesicoureteral reflux (VUR)
- history of acute pyelonephritis
- history of renal obstruction
其他诊断因素
- female sex
- nausea
- elevated blood pressure
- children and infants (risk of VUR)
- adults (risk of XGP and EPN)
- weight loss
- fatigue
- malaise
- cloudy urine
- fever
- back/flank pain and tenderness
危险因素
- neurogenic bladder
- acute pyelonephritis
- vesicoureteral reflux
- obstruction
- renal calculi
- diabetes mellitus
诊断性检查
首要检查
- urinalysis
- renal function
- urine culture
- electrolyte panel
- CBC
- renal ultrasound
- kidney-ureter-bladder (KUB) radiograph
- CT abdomen
需考虑的检查
- MRI abdomen
- voiding cystourethrography (VCUG)
- renal biopsy
治疗流程
all patients
撰稿人
作者
Lynda A. Frassetto, MD
Professor of Medicine
Division of Nephrology
University of California
San Francisco
CA
利益声明
LF declares that she has no competing interests.
鸣谢
Dr Frassetto would like to gratefully acknowledge the assistance of Donna M. Frassetto.
利益声明
DMF declares that she has no competing interests.
同行评议者
Bernard G. Jaar, MD, MPH
Clinical Director
Johns Hopkins School of Medicine
Division of Nephrology
Baltimore
MD
Divulgaciones
BGJ declares that he has no competing interests.
Farah Abifaraj, MD
Clinical Associate
Johns Hopkins School of Medicine
Division of Nephrology
Baltimore
MD
Divulgaciones
FA declares that she has no competing interests.
James Marsh, MA FRCP
Consultant Nephrologist and Clinical Director
Renal Unit
St Helier Hospital
Carshalton
Surrey
UK
Disclosures
JM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
European Association of Urology. Urological infections. 2025 [internet publication].Full text
Vourganti S, Agarwal PK, Bodner DR, et al. Ultrasonographic evaluation of renal infections. Radiol Clin North Am. 2006 Nov;44(6):763-75. Abstract
Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20.Full text Abstract
American Urological Association. Management and screening of primary vesicoureteral reflux in children (2010, amended 2017). 2021 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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- Acute pyelonephritis
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