Pyelonephritis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Acute pyelonephritis is reported to cause more than 100,000 hospitalizations each year with the number of people acquiring pyelonephritis being closer to 250,000, yearly. Pyelonephritis is very common, with 120-130 cases annually per 100,000 women and 30-40 cases per 100,000 men. Females are more commonly affected with pyelonephritis than males.

Epidemiology and Demographics

Incidence

  • On yearly basis pyelonephritis effects 250,000 individuals and is responsible for over a 100,000 hospitalizations.[1][2]
  • Pyelonephritis effects 120-130 cases annually per 100,000 women and 30-40 cases per 100,000 men.[3][4]
  • The incidence of pyelonephritis in 15-34 year old women is 25 cases per 10,000 women annually.[5]
  • The annual outpatient pyelonephritis rate in female population is 12-13 per 10,000 and inpatient rate is 3-4 per 10,000.
  • The annual outpatient pyelonephritis rate in male population is 2-3 per 10,000 and inpatient rate is 1-2 per 10,000.

Prevalence

  • Pyelonephritis is not as common as cystitis. Cystitis is 28 times more common than pyelonephritis.[6][7]
  • The factors affecting prevalence of pathogens in the urinary tract and thus pyelonephritis include:[8][9]

Case-fatality rate/Mortality rate

  • Pyelonephritis has a mortality rate of 10% to 20%, if it is accompanied by bacteremia.[10]

Age

  • The incidence of pyelonephritis is highest in young women. Infant and old individuals are the other categories more prone to pyelonephritis.
  • Xanthogranulomatous Pyelonephritis mostly affects middle aged or older women.
  • The incidence of pyelonephritis in 15-34 year old women is 25 cases per 10,000 women annually.

Race

  • Various studies have shown that pyelonephritis is more prevalent within Asian populations as compared to Caucasians.

Gender

  • Urinary tract infections are the most frequent bacterial infection in women with at least half the women by age 32 reporting at least one episode.[11]
  • Pyelonephritis tends to affect women more than men. This can be attributed to various reasons including the higher incidence of lower UTIs in women due to their shorter and straighter urethra.

Region

  • Pyelonephritis is a common disease that affects everyone worldwide.

References

  1. Ramakrishnan K, Scheid DC (2005). "Diagnosis and management of acute pyelonephritis in adults". Am Fam Physician. 71 (5): 933–42. PMID 15768623.
  2. Hooton TM, Besser R, Foxman B, Fritsche TR, Nicolle LE (2004). "Acute uncomplicated cystitis in an era of increasing antibiotic resistance: a proposed approach to empirical therapy". Clin Infect Dis. 39 (1): 75–80. doi:10.1086/422145. PMID 15206056.
  3. Czaja CA, Scholes D, Hooton TM, Stamm WE (2007). "Population-based epidemiologic analysis of acute pyelonephritis". Clin Infect Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303.
  4. Kurowski K (1998). "The woman with dysuria". Am Fam Physician. 57 (9): 2155–64, 2169–70. PMID 9606306.
  5. Ikäheimo R, Siitonen A, Heiskanen T, Kärkkäinen U, Kuosmanen P, Lipponen P; et al. (1996). "Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women". Clin Infect Dis. 22 (1): 91–9. PMID 8824972.
  6. Czaja CA, Scholes D, Hooton TM, Stamm WE (2007). "Population-based epidemiologic analysis of acute pyelonephritis". Clin. Infect. Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303.
  7. Foxman B, Brown P (2003). "Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs". Infect Dis Clin North Am. 17 (2): 227–41. PMID 12848468.
  8. Efstathiou SP, Pefanis AV, Tsioulos DI, Zacharos ID, Tsiakou AG, Mitromaras AG; et al. (2003). "Acute pyelonephritis in adults: prediction of mortality and failure of treatment". Arch Intern Med. 163 (10): 1206–12. doi:10.1001/archinte.163.10.1206. PMID 12767958.
  9. Copp HL, Halpern MS, Maldonado Y, Shortliffe LD (2011). "Trends in hospitalization for pediatric pyelonephritis: a population based study of California from 1985 to 2006". J Urol. 186 (3): 1028–34. doi:10.1016/j.juro.2011.04.101. PMID 21784477.
  10. Efstathiou, Stamatis P.; Pefanis, Angelos V.; Tsioulos, Dimitrios I.; Zacharos, Ioannis D.; Tsiakou, Aphrodite G.; Mitromaras, Athanasios G.; Mastorantonakis, Stylianos E.; Kanavaki, Sophie N.; Mountokalakis, Theodore D. (2003). "Acute Pyelonephritis in Adults". Archives of Internal Medicine. 163 (10): 1206. doi:10.1001/archinte.163.10.1206. ISSN 0003-9926.
  11. Czaja CA, Scholes D, Hooton TM, Stamm WE (2007). "Population-based epidemiologic analysis of acute pyelonephritis". Clin. Infect. Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303.

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