Chronic pyelonephritis is a long-term kidney infection that involves inflammation and scarring of the renal pelvis and kidney tissue. It is typically caused by recurrent or persistent urinary tract infections (UTIs) that spread from the bladder to the kidneys. Unlike acute pyelonephritis, which is a sudden and severe kidney infection, chronic pyelonephritis develops slowly over time and can lead to persistent kidney damage.
The condition is more common in individuals with structural abnormalities of the urinary tract, such as kidney stones, kidney reflux (vesicoureteral reflux), or urinary tract obstructions. These factors can impair urine flow and create an environment conducive to bacterial growth and infection in the kidneys.
Chronic pyelonephritis is characterized by ongoing inflammation and scarring of the kidney tissue. The repeated infections and inflammation can cause damage to the renal tubules, which are responsible for filtering waste and maintaining electrolyte balance. Over time, the scarring can lead to loss of kidney function and potentially progress to chronic kidney disease.
Symptoms of chronic pyelonephritis can vary and may include recurrent UTIs, frequent urination, urgency to urinate, pain or discomfort in the lower back or sides (flank pain), fatigue, fever, and blood in the urine (hematuria). In some cases, individuals with chronic pyelonephritis may not experience noticeable symptoms until significant kidney damage has occurred.
Diagnosis of chronic pyelonephritis involves a thorough medical history assessment, physical examination, urine analysis (to detect bacteria, white blood cells, and red blood cells), urine culture (to identify the specific bacteria causing the infection), blood tests (to evaluate kidney function and detect signs of infection or inflammation), and imaging studies (such as kidney ultrasound, CT scan, or MRI) to assess the structure and condition of the kidneys.
Treatment for chronic pyelonephritis aims to control the infection, prevent further kidney damage, and manage symptoms. This typically involves a course of antibiotics to eliminate the bacterial infection, as well as addressing any underlying urinary tract abnormalities or obstructions if present. In some cases, surgery may be necessary to correct structural issues that contribute to recurrent infections.
Regular follow-up with a healthcare provider, adherence to treatment plans, and prevention of UTIs through good hygiene practices and appropriate medical interventions are crucial in managing chronic pyelonephritis and preserving kidney function. Close monitoring of kidney function and addressing any complications or progression to chronic kidney disease is essential for long-term management and optimal health outcomes.