Last reviewed: 23 Aug 2023
Last updated: 03 Aug 2021
Summary
Definition
History and exam
Key diagnostic factors
- history of vesicoureteral reflux (VUR)
- history of acute pyelonephritis
- history of renal obstruction
More key diagnostic factors
Other diagnostic factors
- female sex
- nausea
- elevated BP
- children and infants (risk of VUR)
- adults (risk of XGP and EPN)
- weight loss
- fatigue
- malaise
- cloudy urine
- fever
- back/flank pain and tenderness
Other diagnostic factors
Risk factors
- neurogenic bladder
- acute pyelonephritis
- vesicoureteral reflux
- obstruction
- renal calculi
- diabetes mellitus
More risk factors
Diagnostic investigations
1st investigations to order
- urinalysis
- renal function
- urine culture
- electrolyte panel
- CBC
- renal ultrasound
- kidney-ureter-bladder (KUB) radiograph
- CT abdomen
More 1st investigations to order
Investigations to consider
- MRI abdomen
- voiding cystourethrography (VCUG)
- renal biopsy
More investigations to consider
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
Priyanka Sharma, MD
Associate Staff
Cleveland Clinic Foundation
Cleveland
OH
Disclosures
PS 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.
Differentials
- Acute pyelonephritis
- Renal calculi
- Renal cancer
More DifferentialsGuidelines
- Urological infections
- ACR-SPR practice parameter for the performance of renal scintigraphy
More GuidelinesPatient leaflets
Kidney infection
Kidney stones
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