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Related Experiment Videos

Pyelonephritis and acute renal failure.

Anita Nahar1, Michael Akom, Donna Hanes

  • 1Division of Nephrology, University of Maryland Medical Center, Baltimore, Maryland 21201, USA.

The American Journal of the Medical Sciences
|August 18, 2004
PubMed
Summary

Pyelonephritis, a kidney infection, can cause acute renal failure in adults, even without typical risk factors. These cases highlight the importance of considering bacterial kidney infection in acute kidney injury diagnosis.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Acute renal failure (ARF) is often attributed to hypotension, urinary tract obstruction, or nephrotoxic agents.
  • Bacterial pyelonephritis, an infection of the kidney parenchyma, is infrequently recognized as a primary cause of ARF in adults.

Observation:

  • Two adult cases of ARF are presented, occurring without hypotension, obstruction, or nephrotoxins.
  • Case 1: A 48-year-old HIV-positive woman with nonspecific symptoms developed ARF, confirmed as bacterial pyelonephritis via renal biopsy.
  • Case 2: A 33-year-old HIV-positive man presented with fever, diagnosed with pyelonephritis through urine culture and ultrasonography.

Findings:

  • These cases demonstrate that pyelonephritis can be a direct cause of ARF.

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  • The clinical presentations of ARF secondary to pyelonephritis can be varied and present diagnostic challenges.

    • Implications:

    • Clinicians should consider pyelonephritis in the differential diagnosis of ARF, especially in immunocompromised individuals.
    • Early recognition and treatment of bacterial pyelonephritis are crucial to prevent severe renal dysfunction.