What is kidney infection?
Kidney infection is a type of urinary tract infection that usually begins in the lower organs of the urinary tract (urethra and bladder) and then travels up the ureters to one or both kidneys. It can also be carried through the bloodstream from other organs of the body.
The bacterium Escherichia coli (E.coli) is often the causative agent. But it can also be due to viruses or other bacteria.
Kidney infection requires a high degree of medical care as it can lead to permanent kidney damage or the infection can spread through the blood stream to other organs of the body.
Who is at high risk for kidney infection?
People with higher risk for developing kidney infection include:
- Females are at greater risk for kidney infection in comparison to males due to much shorter urethra.
- Blockage of the urinary tract that slows or stops the flow of urine such as kidney stones or enlarged prostate gland in men.
- Anatomical defects such as vesicoureteral reflex (VUR) that causes the urine to flow in the opposite direction and back up to the kidneys leading to infection.
- Impaired immune system such as diabetes mellitus, certain drugs and HIV
- Prolonged catheterization after surgery.
What are the symptoms of a kidney infection?
First, kidney infection starts with symptoms of lower urinary tract infection such as discomfort with urination and frequent urination. However, once the infection has travelled up to the kidneys, you will start to experience more severe symptoms such as:
- Fever and chills
- Nausea and vomiting
- Back/flank pain
- Frequent urination and pain during urination
- Blood or pus with urine
- Children younger than 2 years old may only have a high fever without other symptoms
- Older people may not have any symptoms related to the kidneys; instead, they may exhibit confusion, disordered speech, or hallucinations.
Complications related to kidney infection:
Most cases of kidney infections come to a complete cure. However, if left untreated, it can lead to life-threatening complications that include:
- Permanent kidney damage which lead to chronic kidney disease and kidney failure.
- Spread of infection through the blood stream which leads to life threatening condition called sepsis.
How is a kidney infection diagnosed?
If your physician suspect kidney infection based upon medical history and physical examination, you may be asked to do the following tests:
- General urine test and urine culture to identify the bacteria in the urine
- Blood culture
- Imaging, such as Ultrasound and CT scan, may be necessary to diagnose any blockage or birth defects in the urinary tract that’s leading to repeated kidney infection.
- Antibiotics are the first line of treatment. Your physician may start empiric antibiotics that may be adjusted later according to the results of urine culture. Usually, you will start to improve within few days of antibiotics. But, continuing treatment up to 3 weeks may be necessary.
- Hospitalization may be required for severely ill patients. Giving the antibiotics injected to your veins ensures that the drug is reaching to the kidney.
♦ Urinary Tract Infection Clinical Program
Primary Care Management of Lower UTI in Chronic Kidney Diease (CKD)
Chronic Kidney Disease (CKD) is a significant factor when managing suspected UTI. The stage of CKD plays an important role in infection management and antibiotic treatment. Patients with renal impairment are possibly more likely to have a resistant strain.
It is highly recommended to send urine for culture when UTI is suspected. The goal of this recommendation is to ensure patients are treated with the appropriate antibiotics. The dose and duration of treatment is affected by level of GFR (glomerular filtration rate).
Contributed by: Niloofar Nobakht, MD, FASN
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.