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Acute Pyelonephritis I: Introduction

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...

Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Acute Kidney Injury II: Pathophysiology

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...

Acute Kidney Injury I: Introduction

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...

Dialysis

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...

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Updated: Jul 4, 2026

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Published on: July 18, 2017

Pyelonephritis presenting with severe acute renal failure.

Sriram Krishnamurthy¹, Pankaj Hari, Smriti Hari

¹Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pediatrics

|June 25, 2008

Summary

This case study details an 8-year-old child with acute pyelonephritis, presenting with fever and acute kidney injury. Prompt diagnosis and management with antibiotics and hemodialysis were crucial.

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Area of Science:

Pediatric Nephrology
Infectious Diseases
Renal Pathology

Background:

Acute kidney injury (AKI) in children can stem from various causes, including infections.
Pyelonephritis, a kidney infection, can lead to severe renal complications if not promptly treated.

Observation:

An 8-year-old presented with low-grade fever and significant acute renal failure, indicated by high blood urea and serum creatinine levels.
Microscopic hematuria and proteinuria were noted, suggesting glomerular or tubular damage.
Renal biopsy revealed dense lymphoplasmacytic infiltrate and neutrophils with interstitial necrosis, confirming acute pyelonephritis.

Findings:

Imaging studies, including ultrasonography and MRI, identified multiple renal abscesses.
The patient exhibited severe kidney dysfunction requiring intervention.

Implications:

This case highlights the importance of considering severe kidney infections in pediatric AKI presentations.
Early diagnosis through biopsy and imaging, coupled with appropriate antimicrobial therapy and supportive care like hemodialysis, is vital for managing complex cases of pyelonephritis with renal abscesses.