Pyelonephritis risk factors

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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

Most risk factors of pyelonephritis are similar to those for cystitis and urethritis, since they themselves predispose the individual to pyelonephritis. Common risk factors in the development of pyelonephritis include renal calculi, urinary tract catheterization, pregnancy, diabetes mellitus, and benign prostatic hyperplasia.[1]

Risk Factors

Risk is increased in the following situations:[2][3][4][5][6][7][8][9]

Mechanical/Anatomical

Any structural abnormalities of the kidneys and the urinary tract can lead to abnormal accumulation of bacteria that can reach the renal parenchyma to cause pyelonephritis.

Foreign Body

Other Conditions

General risk factors

  • Change in sexual partner within the last year
  • Spermicide use
  • Decreased expression of CXCR1 (a receptor for IL-8)
  • Genetic predisposition
  • Positive family history (close family members with frequent urination)
  • Young women (reflecting sexual activity in that age group)
  • Infants with anatomical abnormalities and elderly with hormonal abnormalities[10]

References

  1. Hooton TM, Scholes D, Hughes JP, Winter C, Roberts PL, Stapleton AE; et al. (1996). "A prospective study of risk factors for symptomatic urinary tract infection in young women.". N Engl J Med. 335 (7): 468–74. PMID 8672152. doi:10.1056/NEJM199608153350703. 
  2. Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE (2005). "Risk factors associated with acute pyelonephritis in healthy women". Ann. Intern. Med. 142 (1): 20–7. PMID 15630106. 
  3. Ramakrishnan K, Scheid DC (2005). "Diagnosis and management of acute pyelonephritis in adults.". Am Fam Physician. 71 (5): 933–42. PMID 15768623. 
  4. Bergeron MG (1995). "Treatment of pyelonephritis in adults.". Med Clin North Am. 79 (3): 619–49. PMID 7752732. 
  5. Kawamoto A, Sato R, Takahashi K, Luthe SK (2016). "Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis.". BMJ Case Rep. 2016. PMID 27974344. doi:10.1136/bcr-2016-218541. 
  6. Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE (2005). "Risk factors associated with acute pyelonephritis in healthy women.". Ann Intern Med. 142 (1): 20–7. PMC 3722605Freely accessible. PMID 15630106. 
  7. Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stamm WE (2000). "Risk factors for recurrent urinary tract infection in young women.". J Infect Dis. 182 (4): 1177–82. PMID 10979915. doi:10.1086/315827. 
  8. Scholes D, Hawn TR, Roberts PL, Li SS, Stapleton AE, Zhao LP; et al. (2010). "Family history and risk of recurrent cystitis and pyelonephritis in women.". J Urol. 184 (2): 564–9. PMC 3665335Freely accessible. PMID 20639019. doi:10.1016/j.juro.2010.03.139. 
  9. Lundstedt AC, Leijonhufvud I, Ragnarsdottir B, Karpman D, Andersson B, Svanborg C (2007). "Inherited susceptibility to acute pyelonephritis: a family study of urinary tract infection.". J Infect Dis. 195 (8): 1227–34. PMID 17357062. doi:10.1086/512620. 
  10. Czaja CA, Scholes D, Hooton TM, Stamm WE (2007). "Population-based epidemiologic analysis of acute pyelonephritis". Clin. Infect. Dis. 45 (3): 273–80. PMID 17599303. doi:10.1086/519268. 

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