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What is Acute Pyelonephritis?

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Acute pyelonephritis is a sudden and severe kidney infection. This condition causes the kidneys to swell and this condition can permanently damage the kidneys and even be life-threatening. It is important to recognize the symptoms so you can seek immediate medical attention.


Symptoms usually appear within one to two days after the infection begins. They may be different in children and the elderly than they are in adolescents and other adults. However, common symptoms include the following:

  • Fever of more than 102 degrees

  • Abdominal, back, side, or groin pain

  • Painful or burning sensation while urinating

  • Cloudy urine

  • Pus or blood in urine

  • Urgent and/or frequent need to urinate

  • Fishy-smelling urine

Other symptoms may include:

  • Chills

  • Nausea

  • Vomiting

  • General aching or malaise

  • Fatigue

  • Moist skin

  • Mental confusion is common in the elderly

Causes of Acute Pyelonephritis

The infection usually starts in the lower urinary tract as a urinary tract infection. Bacteria enter the body via the urethra and begin to multiply and spread up to the bladder. From the bladder, the bacteria travel up through the ureters to the kidneys. Bacteria, such asEscherichia coli, often cause the infection. But any serious infection in the blood stream can spread to the kidneys and cause acute pyelonephritis.

Risk Factors

When the urinary tract is of unusual size or shape, it is more likely that infections can lead to acute pyelonephritis. A person with chronic kidney stones or other kidney and/or bladder conditions is also at risk. Whenever there is a problem that interrupts the normal flow of urine there is a greater chance of acute pyelonephritis.

A woman’s urethra is much shorter than a man’s, which makes it easy for bacteria to enter the body. This makes women more prone to kidney infections than men and at higher risk for acute pyelonephritis. The elderly also have an increased risk of kidney infections. People with suppressed immune systems, such as those with diabetes, AIDS or cancer, are also at higher risk.

There are also other factors that can make you vulnerable to infection, such as:

  • Catheter

  • Undergoing a cystoscopic examination

  • Having urinary tract surgery

  • Having an enlarged prostate

  • Certain medications

  • Nerve or spinal cord damage

People with vesicoureteral reflux, which is a condition when small amounts of urine back up from the bladder into the ureters and kidneys, are also at high risk for this disease.

Treatment for Acute Pyelonephritis

Antibiotics are the first course of treatment. But the type of antibiotic depends upon whether or not the bacteria can be identified. If the type cannot be identified, a broad-spectrum antibiotic will be used. Although treatment can cure the infection within two to three days, the medication must be taken for the entire prescription period, usually 10 to 14 days.

In some cases, drug therapy is ineffective. For a severe kidney infection, the specialist may admit the patient in hospital, where the patient is given antibiotics intravenously.

Recurrent kidney infections may result from an underlying medical problem. Surgery may be needed to remove any obstructions or correct any structural problems in the kidney that are causing the problem.

Acute Kidney Injury: Global Health Alert

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Acute kidney injury (AKI), also known as acute renal failure, occurs when there is an abrupt or rapid decline in renal filtration function. There is a significant increase in the number of patients being diagnosed with AKI, which is associated with severe morbidity and mortality. It can occur at any age. There are three types of AKI. These are:

  • Prerenal – Is seen mostly in hospitalized patients

  • Intrinsic – Is seen more commonly in the community and hospitalized patients

  • Postrenal – Is seen mostly in hospitalized patients and in the community

When a patient is diagnosed with acute kidney injury, the first thing most specialists do is start intravenous fluids. Usually, saline is used in patients with volume depletion, major trauma, acute blood loss and/or burns. This can reduce the incidence or severity of AKI. In patients diagnosed with hyperkalemia, the situation becomes an emergency and the patients have to be treated with calcium chloride and intravenous dextrose and insulin.

Causes of Acute Kidney Injury

Some of the common causes of AKI are as follows:

Prerenal Failure:

  • Hypovolemia (eg, hemorrhage, gastrointestinal fluid losses, burns)

  • Volume overload with reduced renal perfusion (eg, severe congestive heart failure, advanced hepatic failure)

  • Peripheral vasodilation, as in septic shock

Intrinsic Renal Failure:

  • ATN: ischemic-prolonged prerenal state, sepsis syndrome, systemic hypotension; nephrotoxic-aminoglycoside antibiotics, methotrexate, cisplatinum, myoglobin (rhabdomyolysis), hemoglobin, radiocontrast media

  • Acute interstitial nephritis (AIN): acute allergic nephritis due to antibiotics (sulfa and cephalosporins) and other drugs (furosemide, proton pump inhibitors)

  • Atheroembolic acute kidney injury following vascular procedures or contrast studies

Postrenal Failure:

  • Ureteric obstruction (eg, tumors, stones, fibrosis)

  • Bladder outflow obstruction (eg, prostatism)

There also are certain predisposing and contributory factors for acute kidney injury. These include:

  • Advanced heart disease

  • Systemic sepsis

  • Acute blood loss

  • Severe burns

  • Hepatic failure

  • Acute glomerulonephritis

  • Renal calculi

  • Prostate cancer

  • Bladder cancer

  • Cervical cancer

  • Urethral stricture

  • Benign prostatic hyperplasia

Any sign of acute kidney injury should be treated immediately, as it is an emergency. If left untreated, it could be fatal.

Simple ultrasound treatment may help protect the kidneys

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According to study published in the Journal of the American Society of Nephrology, ultrasound treatments may be able to prevent acute kidney injury, which commonly arises after a person has a major surgery. The study claims that simple and noninvasive ultrasound treatment can work as an effective measure to protect kidneys in patients at risk.

In acute kidney injury, there is a sudden and abrupt deterioration in kidney function. This condition is not only serious, but also prevalent in hospitalized patients. Many times, acute kidney injury occurs after a major surgery as the kidneys do not get normal blood supply during the procedure. Once the injury occurs, there are very few treatment options available to patients. Most of them include supportive care.

Researcher from University of Virginia found that when noninvasive and drug-free ultrasound treatment was give to anesthetized mice, it prevented acute kidney treatment. The researchers found that when these mice were exposed to ultrasound with routine clinical imaging system 24 hours before blood supply to the kidneys was disrupted, the mice showed preserved kidney health after the blood supply was restored. On the other hand, when the mice did not get ultrasound treatment, they showed significant injury to the kidneys. On doing analyses, researchers concluded that the ultrasound treatment stimulated the spleen to produce an anti-inflammatory response, which was responsible for protecting the kidneys.

The researchers believe this simple and noninvasive therapy can actively prevent acute kidney injury. They also believe that a similar mechanism that results in kidney injury could also be responsible for liver, heart and lung damage. Hence, this type of treatment could also be used to prevent injury to other organs after a major surgery. However, more research is needed on the same.

Why does the body reject a transplanted organ

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A Transplant rejection generally occurs when the tissues transplanted in a person is rejected by the body. These tissues are rejected by the entire immunity system of the body. This destroys the transplanted tissues of the body. It is possible to reduce the risk of the rejection of the transplanted tissue if you can determine the molecular similarity between the donor of the tissues and recipient of the tissues. Besides this today doctors use immune suppressant drugs immediately after the transplant, to reduce the risk of a reject. Today, transplants are very common. People undergo eye, heart and many other organ transplants. But the most common of all organ transplants, is kidney transplants.

In most of the cases the kidney transplant cases are successful; there are only few unfortunate cases which face the transplant rejection. Let us understand the reasons what causes the transplant rejection in a kidney transplant procedure. The rejection is caused because the immunity of the body does not accept the transplanted tissues. The immunity system of the body forms a defensive mechanism against these foreign bodies which are introduced to the body. The antigens from the donor kidney do not match with the antigens of the recipient donor and this results in transplant rejection. The main reason for this is that the body recognizes the kidney as foreign body and hence antibodies are produced to fight the kidney being transplanted.

The normal symptoms of kidney transplant rejection once a transplant is done are – the normal functioning of the transplanted kidneys ceases and the kidney fails to work. The urine output of the person decreases to a large extent; they find difficulty in passing urine and because of this they have distention of the abdomen. The person feels uncomfortable, ill and faces a lot of uneasiness. Symptoms like flu, pain and swelling in the area where the organ is transplanted are other common symptoms when the body begins to fight the transplant.