Pyelonephritis

Sounds like 'pie-elo-ne-fri-tis'. Also called kidney infection

Pyelonephritis is an infection of the kidneys that usually starts in the urethra or bladder and moves up via the ureters into the kidneys. It needs to be treated urgently with antibiotics. For a severe kidney infection, your doctor may admit you to the hospital. If not treated quickly, the infection can cause permanent damage to the kidneys.

If you have been given antibiotics and are feeling worse or have more symptoms discussed below, seek medical help right away. Do not wait until the morning.

What are the symptoms of pyelonephritis?

You may have a kidney infection if you have any of these symptoms:

  • Fever and chills.
  • Pain in the lower stomach area, or pain in the lower back (either on one side or both sides).
  • Your urine is pink, cloudy or smells bad.
  • Pain or burning when you pass urine.
  • Wanting to pass urine often but not much urine coming out when you do.
  • Feeling sick (nausea) and vomiting.
  • Loose bowel movements (diarrhoea).

These symptoms usually occur suddenly, over a day or two.

Who is most at risk?

Kidney infections like pyelonephritis tend to be more common in women than men, although men and women over the age of 65 years seem to be affected equally. Pyelonephritis is more common if you:

  • are pregnant
  • have diabetes
  • have a catheter or any tubes in place to drain your bladder
  • have kidney stones
  • have an enlarged prostate.

How is pyelonephritis diagnosed?

Your doctor will talk to you about your symptoms. If your doctor suspects you have a kidney infection, you may be asked to provide a urine sample to test for bacteria, blood or pus is in your urine.

Your doctor may also obtain a blood culture, which is a blood test that checks for bacteria or other organisms in your blood. 

How is pyelonephritis treated? 

You will be prescribed a course of antibiotics to treat the kidney infection. The signs and symptoms of the infection usually start to clear up within a few days of taking the antibiotic, but you must take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely cleared.

Sometimes the antibiotic may need to be changed to a different one after 2 days if:

  • you are not getting better
  • OR the urine test results shows a different antibiotic is needed.

For a severe kidney infection, your doctor may admit you to the hospital. Treatment in the hospital may include antibiotics that you receive through a vein in your arm (intravenously). 

You may also be prescribed medication such as paracetamol for pain and fever.

What can I do to help my recovery?

It is helpful to drink plenty of fluids which will help flush bacteria from your urinary tract. Avoid coffee and alcohol until your infection has cleared, since these can irritate your bladder.

Can pyelonephritis be prevented?

The following simple measure may help to prevent kidney infections:

  • Don't delay urinating – avoid 'holding on'.
  • Make sure your bladder is as empty as possible every time you go.
  • Women should always wipe from the front (vagina) to the back (anus) after urinating or having a bowel motion.
  • Urinate before and soon after sexual intercourse.
  • Drink plenty of water (1.5 to 2 litres a day) to flush bacteria out of the urethra and bladder.

Learn more

The following links provide further information on pyelonephritis. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Kidney infection NHS Choices, UK
Pyelonephritis
Patient Info, UK

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr Janine Bycroft Last reviewed: 22 Mar 2016