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Published on: July 18, 2017

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

Insights

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.

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.
  • 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.

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