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Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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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...
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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...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Predictors of Pyelonephritis in Patients with Urolithiasis: A Retrospective Case-Control Study.

Vahibe Aydın Sarıkaya1, Recep Balık1, Kemal Kayar2

  • 1Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Surgical Infections
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Summary

Pyelonephritis in urolithiasis patients is significantly linked to hydronephrosis, stent presence, and stone burden. Identifying these risk factors aids in early recognition and management of high-risk individuals.

Keywords:
risk factorsurinary tract infectionurine culture testurolithiasis

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Area of Science:

  • Nephrology
  • Urology
  • Infectious Diseases

Background:

  • Pyelonephritis is a common complication in patients with urolithiasis.
  • It complicates urolithiasis management and treatment of urinary tract infections.

Purpose of the Study:

  • To identify risk factors for pyelonephritis in patients with urolithiasis.

Main Methods:

  • Retrospective screening of 8,273 urolithiasis patients (2016-2025).
  • Matched case-control study: 302 patients with pyelonephritis vs. 302 controls.
  • Analysis of demographic and clinical variables as potential risk factors.

Main Results:

  • Hydronephrosis was the strongest independent risk factor (9-fold increased risk).
  • Other significant factors: hypertension, diabetes, CKD, malignant disease, immunosuppression, larger stone burden, multiple/bilateral stones, ureteral stent, prior surgery.
  • Each 1mm increase in stone size correlated with a 2.3% increased risk.

Conclusions:

  • Hydronephrosis, ureteral stent, prior intervention, hypertension, and stone burden are independently associated with pyelonephritis in urolithiasis.
  • Gram-negative bacilli, particularly E. coli, were the most common pathogens.
  • Identifying risk factors can guide preventive and therapeutic strategies for high-risk patients.