The urinary tract is made up of a pair of kidneys, which make urine by filtering the waste products from the blood. Thin tubes known as ureters stem from each kidney and drain the urine into the bladder, which stores the urine until it is excreted out of the body through another tube called a urethra.
Often times, infection-causing bacteria find their way into the urinary tract through the genitals, moving upstream from the urethra to the bladder and traveling up the ureters to infect the kidneys.
At its nascent stages when the infection is restricted to the bladder, the condition is referred to as cystitis. This is a relatively common urinary tract infection and is not associated with any serious damage apart from making urination quite painful and discomforting.
However, if not treated properly, cystitis can progress into a more serious condition as the bacteria multiply and migrate further to infect one or both the kidneys. Although such a kidney infection is relatively easy to cure if caught early, delayed or negligent treatment can cause the bacteria to spread to your bloodstream and cause life-threatening complications. Moreover, the risk of permanent kidney damage also increases.
Some kidney infections can develop without a bladder infection and are due to a problem within the kidney itself. As an example, people with kidney stones or an abnormality of the kidney are more susceptible to kidney infections.
Acute kidney infection refers to a relatively non-threatening form of pyelonephritis wherein the problem resolves completely when adequately treated. However, the condition is said to be chronic if the disease-causing bacteria continue to persist despite the prescribed treatment. As a result, the infection keeps recurring. This kind of sustained damage can severely compromise your kidney function.
Chronic pyelonephritis can even lead to the release of bacteria into the bloodstream, paving the way for subsequent infections in the opposite kidney or elsewhere in the body.
This long-standing condition is usually rooted in certain underlying abnormalities, such as a structural blockage in the urinary tract, large kidney stones that persist, and vesicoureteral reflux, a condition that causes small amounts of urine to flow backward from the bladder into the kidneys or cysts in the kidney.
Although chronic pyelonephritis is comparatively uncommon, most cases are reported in children and people with urinary blockages.
It takes between a few hours to a day for the symptoms of acute pyelonephritis to manifest. Some of the most commonly reported indicators of a probable kidney infection include:
Children with acute pyelonephritis may also exhibit additional symptoms, such as:
Around one in three people with acute pyelonephritis will also have symptoms of a lower urinary tract infection (cystitis). These can include:
Children with long-standing pyelonephritis can exhibit signs and symptoms of poor growth and failure to thrive.
Some people run a higher risk of developing kidney infections than others due to the following factors:
Given that the symptoms of a kidney infection can apply to certain other problems in the pelvis and abdomen, your doctor will have to conduct a thorough evaluation to reach a conclusive diagnosis.
To that end, your health care provider may use the following tests:
Your doctor will also look for problems that can cause kidney infection, such as kidney stones and birth defects. Your treatment will be based on a clear diagnosis of the problem.
The first line of treatment for pyelonephritis involves a doctor-prescribed course of antibiotics to eliminate the bacteria. The choice of drug will depend upon the bacteria detected on the urine tests.
If the infecting pathogen remains unidentified, your doctor will recommend a broad-spectrum antibiotic that will treat the most commonly seen bacteria in this condition. The severity of your symptoms helps decide the choice of antibiotic and duration of the treatment.
Although your condition will show signs of improvement within a few days of taking the antibiotic, it is imperative that you complete the full course of antibiotics prescribed by your doctor to ensure that the infection is completely eradicated.
On occasion, the doctor may change your medication after 2 days, particularly in the event that:
Oral drugs sometimes prove ineffective and insufficient for treating severe kidney infections. People who exhibit particularly severe symptoms, such as considerable nausea and vomiting, persistently high fever, signs of dehydration, and debilitating pain, may need to be hospitalized for a few days.
Treatment in the hospital may include intravenous administration of antibiotics and fluids as well as regular sampling of your blood and urine to track the improvement of the infection. Your stay at the hospital usually depends upon how well you respond to the treatment, and once you are released, the doctor will give you 10 to 14 days’ worth of oral antibiotics to take home.
A kidney infection generally results due to the advancement of preexisting bacteria from the lower urinary tract up to the kidneys. Thus, the ideal way to stave off the threat of kidney infections is by not having bacteria in the urethra or bladder. The following preventive steps can help in this regard:
Kidney infections can take a turn for the worst if left untreated and lead to complications that can jeopardize your health to the extent of being fatal. Thus, it is paramount that you consult with your healthcare provider the minute you notice possible signs of pyelonephritis. The onset of certain symptoms particularly warrants the need for prompt medical assistance, which include:
Professional medical help is especially indispensable in the case of children who may have a kidney infection.
The usual line of questioning that a doctor follows to evaluate your condition touches upon the following:
Negligent or delayed treatment of acute pyelonephritis can give rise to potentially serious complications:
As far as chronic pyelonephritis is concerned, the outlook of this condition tends to vary from patient to patient. For the majority of patients, the condition is characterized by occasional bouts of kidney infection without any major discomfort or pain. Others require regular monitoring by a kidney specialist.
In some patients, the infection causes significant damage to the kidneys, resulting in a significant impairment of kidney function leading to kidney failure. In such extreme cases, the patient may require long-term dialysis or a kidney transplant.
If not treated in time, a kidney infection can lead to serious complications and can permanently damage your kidneys. Often, antibiotics are recommended to treat the infection. You can also use some home remedies to reduce the symptoms and promote healing.
Here are the some home remedies for a kidney infection.
Increasing your fluid intake when suffering from a kidney infection can help reduce the symptoms and promote quick recovery. It will help flush out bacteria, waste, and toxic products from your kidneys, keeping them clean and healthy.
A study published in the American Journal of Nephrology suggested a potentially protective effect of higher total water intake, particularly plain water, on the kidney. However, evidence from a large, well-designed randomized controlled trial is needed to conclusively establish this claim.
Pain in the lower abdomen, back, and hips is very common when suffering from a kidney infection. You can apply hot compresses to reduce the pain, relax the muscles of your abdomen, and relieve the pressure from your bladder.
Cranberry juice is reported to reduce urinary tract infections. However, there is no strong data to support its use for urinary tract infections.
Cranberry juice contains certain chemicals that may deter the bacteria from sticking to the urinary tract. This may prevent bacteria from thriving on the wall of the bladder and thus lessens your risk of infection.
In one study, researchers found that cranberry juice reduced E. coli colonization of the bladder in an experimental mouse model of urinary tract infection and that the organic acids are active agents. The active treatments reduced bacterial counts in the bladder but did not cure the infection, indicating that cranberry juice is not a definitive treatment but it may promote clearance of the infection, for instance, in combination with antibiotics.
Consider drinking a glass of unsweetened cranberry juice. Do not drink this juice in large amounts or for extended time periods as it can cause side effects. Drinking more than 1 liter of this juice daily for a long time may increase the chances of developing kidney stones because it contains oxalates.
Many cranberry juice products contain significant amounts of sugar, so it is important to check if you have diabetes.
Yogurt that contains antioxidants and probiotics can help treat a kidney infection and even prevent it from recurring. The live bacteria in yogurt inhibit adherence of bacteria to the epithelial cells of the urinary tract. Moreover, yogurt helps boost the immune system.
Vitamin C helps your immune system to fight off infection. It acidifies the urine, thus making it difficult for the infection-causing bacteria to grow.
A study published in Advances in Urology showed that administration of antioxidants, namely, vitamins A and E, can prevent the scarring of kidneys due to pyelonephritis, with or without antibiotic administration.
Another study showed that the combined intake of vitamin E and vitamin C exerts a protective role against hydroxyl-L-proline (HLP)-induced oxalate nephropathy.
Parsley juice works as a cleanser for the kidneys by promoting increased urine flow. This means it can help flush out harmful toxins and microorganisms present in the kidneys.
The natural antibiotic properties of garlic can also help fight kidney infection. Moreover, it acts as a diuretic to help the kidneys flush out harmful toxins and microorganisms from the body.
A study published in Pathogens and Disease showed that oral treatment with garlic significantly lowered renal bacterial counts and protected mouse kidney from tissue destruction caused by P. aeruginosa. Prophylactic treatment with garlic was able to significantly lower renal bacterial counts in test group animals. Renal tissue lesions were of less severity in the garlic-treated group, suggesting attenuation of virulence of P. aeruginosa in the UTI model.
Apple cider vinegar contains malic acid, which has antibacterial properties that can help in treating kidney infections that are particularly caused by E. coli. Plus, it can help balance the pH levels in the body and prevent the infection from spreading.
Apples are high in fiber and anti-inflammatory properties and thus help treat kidney infections. Apples can prevent harmful bacteria from growing. Regular consumption of this fruit can even reduce the risk of kidney-related problems.
Answered by Dr. Seyedmahdi Pahlavani, M.D. (Nephrologist)
Kidney infection is a serious condition and may lead to blood-stream infection (known as sepsis), local expansion of infection (abscess formation), and kidney failure if left untreated. The appropriate antibiotic regimen should be chosen based on patient’s condition and underlying etiologic pathogen for prompt treatment of kidney infection (pyelonephritis) to avoid complications.
The severity of pyelonephritis depends on many factors such as, type of pathogen, patient’s age, gender, immune status, and other co-morbidities. It may result in blood stream infection (known as sepsis), if left untreated, which has a very high mortality rate.
Treatment of pyelonephritis could be complicated in elderly individuals, pregnant patients, patients with immunosuppression, patients with a current kidney stone, and patients with recent history of hospitalization and antibiotic treatment and it could be fatal in these groups of patients.
Prompt treatment by seeking medical attention is the first step to protect your kidneys from potential complications from pyelonephritis. Once the diagnosis is confirmed, follow the instructions provided by your healthcare provider and ensure you have completed the antibiotic course.
Sometimes, you need to confirm the infection’s eradication by a urine test after the treatment has completed.
Sexually transmitted disease may increase the chance of urinary tract infection but it is very unusual that a kidney is infected because of sexual activity.
Pyelonephritis may cause scars in kidney parenchyma and recurrent infections will increase the chance of chronic kidney disease (CKD) and eventually end-stage renal disease (ESRD) in long term. However, severe pyelonephritis may cause acute kidney failure.
On the other hand, a complicated form of pyelonephritis that is called xanthogranulomatous pyelonephritis requires nephrectomy (surgical removal of affected kidney).
It is important to have regular visits to your healthcare provider to diagnose kidney dysfunction at early stages especially if you have a risk factor for kidney diseases like diabetes, hypertension, and chronic recurrent infections.
Controlling blood pressure and maintaining good diabetes control are the major conditions to decrease the rate of declining kidney function and its rate of progression.
A healthy diet and regular exercise may play an important role in maintaining a good blood pressure and glucose control and will eventually result in maintaining good kidney function.
About Dr. Seyedmahdi Pahlavani, MD: Dr. Pahlavani earned his MD degree from Zahedan University of Medical Sciences after which he did his post graduate training in internal medicine at Tehran University of Medical Sciences. He was the chief resident at Rasool Akram hospital and was selected as best resident of internal medicine in 2010.
Dr. Pahlavani joined PERFUSE study group at Beth Israel Deaconess Medical Center as postdoctoral research fellow when he had many scholarly activities. He started his fellowship training in nephrology at Saint Louis University Hospital (SLUH) in 2018 and currently is a senior fellow at SLUH.
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