Pyelonephritis Flashcards
pyelonephritis
upper UTI w/ inflm of renal pelvis & parenchyma
- acute and chronic forms
pyelo- suffix meaning
renal calices & pelvis
etiology
- bacterial infection (usually E.coli; Staphylococcus aureus via blood)
risks
- suppressed immunity
- catheterization
- urinary reflux
- diabetes mellitus
why is catheterization a risk
Introduce microbes into bladder, migrates up ureters into kidney
example of urinary reflux
BPH – d/t compression of prostate on urethra
why is diabetes mellitus a risk
Inadequate perf –> dec defense cells & immunity –> surface proteins become glycosylated & WBCs dec Fx –> glycosuria provides nutrients for bacteria
patho
- typical bacterial infection
- bacteria enters, proliferates, & causes cmplx
- Bacteria advance from urethra –> bladder –> ureter –> kidney –> infect & inflm
- Kidney does not have large amounts of empty space, so bacteria proliferates within tissue & damage parenchyma
- Possibility of fibrosis & scar tissue (non-Fx tissue) –> dec kidney Fx
chronic form cause & patho
- Self-perpetuating
- Arise d/t lack of intervention, unsuccessful intervention, recurring infections or progression from acute form
- Reflux on an ongoing basis –> recurring infections –> prog renal damage –> chronic inflm –> irreversible renal damage –> possible renal failure
mnfts
- acute onset
- lower back pain (more severe than UTI)
- fever
- frequency, dysuria, urgency
- pyuria
- edema & HTN
why does fever mnft
d/t infection impacting vital organs
what is pyuria and why does it mnft
= pus in urine
d/t bacteria
why does edema & HTN mnft
d/t fluid retention
- causes dec kidney Fx –> dec abiltiy to excrete fluid
Tx
- Abx
- minimize kidney damage (anti-inflm)
- symptomatic management
how long Abx used for
10-14 days (longer than UTI)
