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__NOTOC__
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{{Pyelonephritis}}
{{Pyelonephritis}}
{{CMG}}; {{AE}} {{USAMA}}


{{CMG}}
==Overview==
==Overview==
Common risk factors in the development of pyelonephritis include renal [[calculi]], urinary tract catheterization, [[pregnancy]], [[diabetes mellitus]], urinary tract stents, and [[benign prostatic hyperplasia]].
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 catheterization|urinary tract catheterization]], [[pregnancy]], [[diabetes mellitus]], and [[benign prostatic hyperplasia]].


==Risk Factors==
==Risk Factors==
Risk is increased in the following situations:<ref>{{cite journal |author=Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE |title=Risk factors associated with acute pyelonephritis in healthy women |journal=Ann. Intern. Med. |volume=142 |issue=1 |pages=20-7 |year=2005 |pmid=15630106 |doi=}}</ref>
Risk is increased in the following situations:<ref>{{cite journal |author=Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE |title=Risk factors associated with acute pyelonephritis in healthy women |journal=Ann. Intern. Med. |volume=142 |issue=1 |pages=20-7 |year=2005 |pmid=15630106 |doi=}}</ref><ref name="pmid15768623">{{cite journal| author=Ramakrishnan K, Scheid DC| title=Diagnosis and management of acute pyelonephritis in adults. | journal=Am Fam Physician | year= 2005 | volume= 71 | issue= 5 | pages= 933-42 | pmid=15768623 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15768623  }} </ref><ref name="pmid7752732">{{cite journal| author=Bergeron MG| title=Treatment of pyelonephritis in adults. | journal=Med Clin North Am | year= 1995 | volume= 79 | issue= 3 | pages= 619-49 | pmid=7752732 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7752732  }} </ref><ref name="pmid27974344">{{cite journal| author=Kawamoto A, Sato R, Takahashi K, Luthe SK| title=Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis. | journal=BMJ Case Rep | year= 2016 | volume= 2016 | issue=  | pages=  | pmid=27974344 | doi=10.1136/bcr-2016-218541 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27974344  }} </ref><ref name="pmid15630106">{{cite journal| author=Scholes D, Hooton TM, Roberts PL, Gupta K, Stapleton AE, Stamm WE| title=Risk factors associated with acute pyelonephritis in healthy women. | journal=Ann Intern Med | year= 2005 | volume= 142 | issue= 1 | pages= 20-7 | pmid=15630106 | doi= | pmc=3722605 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15630106  }} </ref><ref name="pmid10979915">{{cite journal| author=Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stamm WE| title=Risk factors for recurrent urinary tract infection in young women. | journal=J Infect Dis | year= 2000 | volume= 182 | issue= 4 | pages= 1177-82 | pmid=10979915 | doi=10.1086/315827 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10979915  }} </ref><ref name="pmid20639019">{{cite journal| author=Scholes D, Hawn TR, Roberts PL, Li SS, Stapleton AE, Zhao LP et al.| title=Family history and risk of recurrent cystitis and pyelonephritis in women. | journal=J Urol | year= 2010 | volume= 184 | issue= 2 | pages= 564-9 | pmid=20639019 | doi=10.1016/j.juro.2010.03.139 | pmc=3665335 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20639019  }} </ref><ref name="pmid17357062">{{cite journal| author=Lundstedt AC, Leijonhufvud I, Ragnarsdottir B, Karpman D, Andersson B, Svanborg C| title=Inherited susceptibility to acute pyelonephritis: a family study of urinary tract infection. | journal=J Infect Dis | year= 2007 | volume= 195 | issue= 8 | pages= 1227-34 | pmid=17357062 | doi=10.1086/512620 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17357062  }} </ref>


* Mechanical: any structural abnormalities to the kidneys and the urinary tract, [[Kidney stone|calculi]] (kidney stones), [[Urinary catheterization|urinary tract catheterization]], urinary tract stents or drainage procedures (e.g. [[nephrostomy]]), [[pregnancy]], neuropathic bladder (e.g. due to spinal cord damage, [[spina bifida]] or [[multiple sclerosis]]) and [[prostate]] disease (e.g. [[benign prostatic hyperplasia]]) in men
===Mechanical/Anatomical===
* Constitutional: [[diabetes mellitus]], [[immunocompromised]] states
Any structural abnormalities of the [[kidney]]s and the [[urinary tract]] can lead to abnormal accumulation of bacteria that can reach the renal [[parenchyma]] to cause pyelonephritis.
* Behavioral: change in sexual partner within the last year, [[spermicide]] use
 
*[[Kidney stones]] or [[Kidney stone|calculi]]
*[[Vesicoureteral reflux]] (VUR) abnormal backward flow or [[reflux]] of urine, can occur post surgically
*[[Posterior urethral valves|Posterior urethral valve]]
*[[Pregnancy]]
*[[Urinary catheterization|Urinary tract catheterization]] or stents
*Drainage procedures (e.g. [[nephrostomy]])
*[[Prostate]] disease (e.g. [[benign prostatic hyperplasia]]) in men
*[[Polycystic kidney disease|Polycystic Kidney]]
*Bladder neck obstruction
*[[Horseshoe kidney]]
*[[Ureterocele]]
*Neuropathic bladder (e.g. spinal cord damage, [[spina bifida]] or [[multiple sclerosis]])
*[[Incontinence]]
 
===Foreign Body===
*Urinary [[catheters]]
*[[Calculus]]
*[[Tumors|Tumours]]
 
===Other Conditions===
*[[Cystitis]]
*[[Urethritis]]
*[[Prostatitis]]
*[[Diabetes mellitus]]  
*[[Immunocompromised]] states
*[[Sickle cell disease]]
*[[Transplantation]]
*[[Pregnancy]]
*[[HIV]]
*[[Chemotherapy]]
 
===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)
* Positive family history (close family members with frequent urination)
* Young women are most likely to be affected, traditionally reflecting [[Human sexual behavior|sexual activity]] in that age group.
* Young women (reflecting sexual activity in that age group)
* Infants and the elderly are also at increased risk, reflecting anatomical abnormalities and hormonal status.<ref>{{cite journal |author=Czaja CA, Scholes D, Hooton TM, Stamm WE |title=Population-based epidemiologic analysis of acute pyelonephritis |journal=Clin. Infect. Dis. |volume=45 |issue=3 |pages=273-80 |year=2007 |pmid=17599303 |doi=10.1086/519268}}</ref>
* Infants with anatomical abnormalities and elderly with hormonal abnormalities<ref>{{cite journal |author=Czaja CA, Scholes D, Hooton TM, Stamm WE |title=Population-based epidemiologic analysis of acute pyelonephritis |journal=Clin. Infect. Dis. |volume=45 |issue=3 |pages=273-80 |year=2007 |pmid=17599303 |doi=10.1086/519268}}</ref>
*Urine can also back up, or reflux, into one or both kidneys. This problem, which is called [[vesicoureteral reflux]] (VUR), happens when the valve mechanism that normally prevents backward flow of urine is not working properly. VUR is most commonly diagnosed during childhood.
*Pregnant women and people with diabetes or a weakened [[immune system]] are also at increased risk of pyelonephritis.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Medicine]]
[[Category:Infectious disease]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Inflammations]]
[[Category:Urology]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Primary care]]
[[Category:Emergency medicine]]
 
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Latest revision as of 23:54, 29 July 2020

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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.

Risk Factors

Risk is increased in the following situations:[1][2][3][4][5][6][7][8]

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[9]

References

  1. 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.
  2. Ramakrishnan K, Scheid DC (2005). "Diagnosis and management of acute pyelonephritis in adults". Am Fam Physician. 71 (5): 933–42. PMID 15768623.
  3. Bergeron MG (1995). "Treatment of pyelonephritis in adults". Med Clin North Am. 79 (3): 619–49. PMID 7752732.
  4. Kawamoto A, Sato R, Takahashi K, Luthe SK (2016). "Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-218541. PMID 27974344.
  5. 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 3722605. PMID 15630106.
  6. 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. doi:10.1086/315827. PMID 10979915.
  7. 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. doi:10.1016/j.juro.2010.03.139. PMC 3665335. PMID 20639019.
  8. 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. doi:10.1086/512620. PMID 17357062.
  9. 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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