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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 III: Clinical Manifestations

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...

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: May 28, 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

Electrolyte disturbances in acute pyelonephritis.

Maite Augusta Gil-Ruiz¹, Andrés José Alcaraz, Rafael José Marañón

¹Pediatric Emergency Department, Gregorio Marañón University General Hospital, Madrid, Spain. maitegilr@gmail.com

Pediatric Nephrology (Berlin, Germany)

|October 11, 2011

Summary

Infants with acute pyelonephritis may show renal unresponsiveness to aldosterone, leading to hyperkalemia. This condition, characterized by inadequate renal potassium excretion, is linked to inflammation and infant kidney immaturity.

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Establishment and Characterization of UTI and CAUTI in a Mouse Model

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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

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Published on: July 18, 2017

Establishment and Characterization of UTI and CAUTI in a Mouse Model

Establishment and Characterization of UTI and CAUTI in a Mouse Model

Published on: June 23, 2015

Area of Science:

Pediatric Nephrology
Infectious Diseases
Endocrinology

Background:

Acute pyelonephritis (APN) is a common kidney infection in infants.
Aldosterone is crucial for regulating potassium balance in the kidneys.
Infant kidneys have immature tubular function, potentially affecting electrolyte regulation.

Purpose of the Study:

To investigate renal unresponsiveness to aldosterone in infants with APN.
To identify clinical characteristics of infants with inadequate renal potassium excretion.
To explore the role of inflammation and immaturity in this condition.

Main Methods:

Studied 113 infants with APN (fever >38°C, bacteriuria).
Compared electrolyte and renal tubular function tests with 75 febrile infants without bacteriuria.
Defined inadequate response by hyperkalemia and low transtubular potassium gradient (TTKG).

Main Results:

Infants with APN showed hyperkalemia (>5.5 mmol/L).
APN group had lower TTKG and higher fractional sodium excretion.
Younger infants with APN were more prone to inadequate renal response to hyperkalemia.

Conclusions:

Infants with APN can exhibit renal unresponsiveness to aldosterone, causing hyperkalemia.
Renal interstitial inflammation and infant kidney immaturity likely contribute to this altered response.
This occurs even without urinary tract anomalies or obstruction.