Chronic pyelonephritis

Chronic Pyelonephritis is a medical condition characterized by chronic inflammation of the kidney due to recurrent or persistent renal infection or due to an obstruction in the urinary tract. This condition can lead to renal failure if not properly managed.

Etiology

Chronic pyelonephritis is usually caused by bacterial infections. The most common bacteria involved are Escherichia coli and Klebsiella pneumoniae. Other causes include urinary tract obstruction due to kidney stones, tumors, or congenital abnormalities.

Pathophysiology

In chronic pyelonephritis, the recurrent or persistent infections or obstructions lead to inflammation and scarring of the renal parenchyma, the functional tissue of the kidney. This can result in the loss of kidney function over time.

Clinical Presentation

Patients with chronic pyelonephritis may present with symptoms such as fever, flank pain, nausea, vomiting, and urinary symptoms such as frequent urination, painful urination, and blood in the urine. In severe cases, patients may develop signs of renal failure.

Diagnosis

The diagnosis of chronic pyelonephritis is based on the patient's clinical history, physical examination, and laboratory tests. Urinalysis and urine culture can help identify the causative bacteria. Imaging studies such as ultrasound and computed tomography (CT) scan can help identify any obstructions in the urinary tract.

Treatment

The treatment of chronic pyelonephritis involves the use of antibiotics to treat the infection and management of any underlying obstructions in the urinary tract. In severe cases, dialysis or kidney transplantation may be required.

Prognosis

The prognosis of chronic pyelonephritis depends on the severity of the disease and the patient's response to treatment. If left untreated, it can lead to renal failure and other serious complications.

See Also

• Acute pyelonephritis
• Urinary tract infection
• Renal failure