Treatment of kidney infections

Kidney infections, or pyelonephritis, is a specific type of urinary tract infection that may begin in the bladder and travels up into the kidneys. If a kidney infection is not treated properly it can cause permanent damage to the kidneys or even spread into the bloodstream and caused a life-threatening infection. If you believe that you may have a kidney infection based on your symptoms it is important to seek the advice of your primary care physician in order to decrease your risk of any permanent damage to the kidneys.

The kidneys are two bean shaped organs located mid back just under the last rib. They are responsible for filtering waste from the blood and adjusting your blood pressure. The kidneys also help the body to conserve or excrete water from the system depending upon the needs of the body.

Symptoms of a kidney infection will include back pain, fever, severe abdominal pain, fatigue, mental changes or confusion, urination problems such as blood in the urine, cloudier abnormal urine color, increased urinary frequency or urgency, need to urinate at night or painful urination. Individuals may also suffer from nausea and vomiting.

The goals of treatment are to control the infection and relieve the symptoms that the individual is experiencing. Because there is a high death rate in the elderly population who experiences pyelonephritis or a kidney infection, and because of the risk of complications, very prompt treatment is recommended. Acute symptoms will usually go away within 48 to 72 hours after an individual has started on the appropriate antibiotics.

Initially, the physician will order a broad spectrum antibiotic and at the same time order a culture and sensitivity of the urine. This is a test in which the urine is collected and sent to the lab. At the lab the urine is placed in petri dishes which contained growth medium. The objective is to encourage the growth of the bacteria which already exists in the urine. Once the bacteria has grown out the lab technicians will identify it and determine, through another test, which antibiotic will best treat the bacteria.

The challenge exists in individuals who have chronic bacterial infections in their bladder or kidneys. In these individuals there is often not just the over growth of one bacteria, but in fact may have been over growth of two or more bacteria which are not all susceptible to the same antibiotic. In the case of individuals who have a chronic bacterial infection or other chronic underlying medical conditions, such as diabetes, HIV or paraplegia, physicians may order a 10 to 14 day course of antibiotics as opposed to the normal three to seven days.

Some individuals have an infection which is so severe that they are unable to take the antibiotics by mouth because of their problems with nausea and vomiting. In this case they may be hospitalized and given the antibiotics intravenously, through a vein.

The most common drugs used to treat a kidney infection are sulfa based. If you have an allergy to sulfa drugs let the physician know immediately so that a different course of medication can be ordered.

With treatment most kidney infections will resolve without complications. However, even a mild kidney infection may require aggressive or prolonged treatment protocols in order to negate any complications. Acute kidney injury, renal failure, can happen if a severe infection leads to very low blood pressure. This is more common in the elderly, infants and individuals who have a weakened immune system. Oftentimes, these individuals will be admitted to the hospital for frequent monitoring and other medications as necessary, even when the infection does not appear to be severe.

Individuals who have recurrent kidney infections and do not have any other underlying medical conditions, should be evaluated for underlying structural abnormalities. In this case your physician will refer you to a nephrologist, kidney doctor, for an evaluation to determine if abnormalities are causing these infections. In this case, surgical reconstruction may be required in order to prevent any further kidney infections and possible permanent damage.

RESOURCES

MayoClinic: Kidney Infection

NHS Choice: Kidney Infection

NHS CHoices: Kidney Infection

National Kidney and Urologic Diseases Information Clearinghouse: Pyelonephritis Kidney Infection

MayoClinic: Kidney Infection