Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- history of vesicoureteral reflux (VUR)
- history of acute pyelonephritis
- history of renal obstruction
Outros fatores diagnósticos
- 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
Fatores de risco
- neurogenic bladder
- acute pyelonephritis
- vesicoureteral reflux
- obstruction
- renal calculi
- diabetes mellitus
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- urinalysis
- renal function
- urine culture
- electrolyte panel
- CBC
- renal ultrasound
- kidney-ureter-bladder (KUB) radiograph
- CT abdomen
Investigações a serem consideradas
- MRI abdomen
- voiding cystourethrography (VCUG)
- renal biopsy
Algoritmo de tratamento
all patients
Colaboradores
Autores
Lynda A. Frassetto, MD
Professor of Medicine
Division of Nephrology
University of California
San Francisco
CA
Declarações
LF declares that she has no competing interests.
Agradecimentos
Dr Frassetto would like to gratefully acknowledge the assistance of Donna M. Frassetto.
Declarações
DMF declares that she has no competing interests.
Revisores
Bernard G. Jaar, MD, MPH
Clinical Director
Johns Hopkins School of Medicine
Division of Nephrology
Baltimore
MD
Declarações
BGJ declares that he has no competing interests.
Farah Abifaraj, MD
Clinical Associate
Johns Hopkins School of Medicine
Division of Nephrology
Baltimore
MD
Declarações
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
Declarações
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.
Referências
Principais artigos
European Association of Urology. Urological infections. 2025 [internet publication].Texto completo
Vourganti S, Agarwal PK, Bodner DR, et al. Ultrasonographic evaluation of renal infections. Radiol Clin North Am. 2006 Nov;44(6):763-75. Resumo
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.Texto completo Resumo
American Urological Association. Management and screening of primary vesicoureteral reflux in children (2010, amended 2017). 2021 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Acute pyelonephritis
- Renal calculi
- Renal cancer
Mais Diagnósticos diferenciaisDiretrizes
- Urological infections
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