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Pielonefrite crônica

Last reviewed: 9 Apr 2025
Last updated: 17 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • história de refluxo vesicoureteral (RVU)
  • história de pielonefrite aguda
  • história de obstrução renal
Full details

Other diagnostic factors

  • sexo feminino
  • náuseas
  • pressão arterial elevada
  • crianças e lactentes (risco de RVU)
  • adultos (risco de pielonefrite xantogranulomatosa [PNX] e pielonefrite enfisematosa [PNE])
  • perda de peso
  • fadiga
  • mal-estar
  • urina turva
  • febre
  • dor e sensibilidade nas costas/flanco
Full details

Risk factors

  • bexiga neurogênica
  • pielonefrite aguda
  • refluxo vesicoureteral
  • obstrução
  • litíase renal
  • diabetes mellitus
Full details

Diagnostic tests

1st tests to order

  • urinálise
  • função renal
  • urocultura
  • painel de eletrólitos
  • Hemograma completo
  • ultrassonografia renal
  • ultrassonografia de rins, ureteres e bexiga (RUB)
  • tomografia computadorizada (TC) abdominal
Full details

Tests to consider

  • ressonância nuclear magnética (RNM) do abdome
  • cistouretrografia miccional
  • biópsia renal
Full details

Treatment algorithm

ONGOING

todos os pacientes

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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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