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Chronic pyelonephritis

Last reviewed: 22 Nov 2024
Last updated: 17 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • history of vesicoureteral reflux (VUR)
  • history of acute pyelonephritis
  • history of renal obstruction
Full details

Other diagnostic factors

  • 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
Full details

Risk factors

  • neurogenic bladder
  • acute pyelonephritis
  • vesicoureteral reflux
  • obstruction
  • renal calculi
  • diabetes mellitus
Full details

Diagnostic tests

1st tests to order

  • urinalysis
  • renal function
  • urine culture
  • electrolyte panel
  • CBC
  • renal ultrasound
  • kidney-ureter-bladder (KUB) radiograph
  • CT abdomen
Full details

Tests to consider

  • MRI abdomen
  • voiding cystourethrography (VCUG)
  • renal biopsy
Full details

Treatment algorithm

ONGOING

all patients

Contributors

Authors

Lynda A. Frassetto, MD

Professor of Medicine

Division of Nephrology

University of California

San Francisco

CA

Disclosures

LF declares that she has no competing interests.

Acknowledgements

Dr Frassetto would like to gratefully acknowledge the assistance of Donna M. Frassetto.

Disclosures

DMF declares that she has no competing interests.

Peer reviewers

Bernard G. Jaar, MD, MPH

Clinical Director

Johns Hopkins School of Medicine

Division of Nephrology

Baltimore

MD

Disclosures

BGJ declares that he has no competing interests.

Farah Abifaraj, MD

Clinical Associate

Johns Hopkins School of Medicine

Division of Nephrology

Baltimore

MD

Disclosures

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.

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