Kidney Infection (Pyelonephritis)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Author: Siamak N. Nabili, MD, MPH
    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What are risk factors for kidney and urinary tract infection (UTI)?

There are many factors that may increase the chances for infection of the kidneys and urinary tract.

Premenopausal women are at higher risk for developing UTI and kidney infection. Risk factors within this population include:

  • Sexual intercourse (for women -- may increase the risk of urinary tract infection because of possible introduction of the bacteria around the urethra into the urinary system [a condition sometimes referred to as "honeymoon cystitis"])
  • Previous urinary tract infection
  • Use of spermicides
  • History of mother with recurrent UTIs (which suggests a possible genetic component to susceptibility)
  • Pregnancy

In fact, some pregnant women may have urinary infections during their pregnancy. This may occur because of slower transit of urine in the ureters during pregnancy from the pressure applied by the enlarging uterus.

In post-menopausal women, physiological factors (vaginal dryness, urinary incontinence, urinary retention, and prolapse of the pelvic organs) seem to add potential risk to develop UTIs and kidney infections.

In men, prostate enlargement is the main risk factor for UTI and kidney infection.

Urinary catheters (Foley catheters) also increase the risk of developing urinary and kidney infections. These catheters are used in settings where an individual may not be able to urinate due to paralysis (neurogenic bladder), severe illness, bed bound state, incontinence of urine (inability to hold their urine), or bladder dysfunction. Urinary catheters simply provide a physical vehicle for the bacteria from outside to be directly transported into the bladder and the urinary system.

Kidney stones and structural abnormalities of the urinary system may also cause kidney infection. Impaired draining and blockage of urine (urinary retention) may cause bacteria to ascend to the kidney without being washed back down with the urine. Any obstruction to the flow of urine can serve as a focus of infection that can spread to other parts of the urinary tract.

Urinary stents placed in ureters to relieve obstruction due to stones or tumors are also a potential risk for kidney infection. As matter of fact, any instrumentation or procedure of the urinary system (stenting, cystoscopy, biopsy, and transurethral resection of the prostate (TURP) can pose a risk for infection of the urinary tract.

Diabetes may also increase the risk of kidney infection in both men and women. Other conditions or medications that suppress immune function increase the risk of kidney infection.

In children, risk factors for kidney infection include female gender, uncircumcised male, structural abnormalities of the urinary tract, and Caucasian race (four times higher than African American). Continue Reading

Reviewed on 7/27/2015
References
REFERENCES:

Gupta, Kalpana, et al. "Urinary Tract Infection." Annals of Internal Medicine 156.5 (2012): ITC3-1.

NIH. Pyelonephritis: kidney infection. Updated Jun, 11 2012.

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