Kidney Infection. A life-threatening urinary tract infection.

How common are kidney infections?

In the UK alone, over 150,000 people are admitted to hospitals with kidney infections yearly, making it a significant health concern.

Treated promptly, most kidney infections resolve, and severe complications like kidney failure and other kidney diseases are avoided.

What causes Kidney Infections

Kidney infections occur when bacteria enter the urinary tract and reach the kidneys.

Bacteria can enter the urinary tract through the urethra (the water pipe that carries urine out of the body) and travel up to the bladder and the kidneys.

The most common cause of kidney infections is a type of bacteria called Escherichia coli (E. coli), which is usually found in the gut. Other types of bacteria can also cause kidney infections, such as Klebsiella, Enterobacter, and Proteus.

What are the risk factors for kidney infection?

Some people are more prone to kidney infections than others.

• Women are more prone to develop kidney infections than men because a woman's urethra is shorter and closer to the back passage, making it easier for bacteria to access the urinary tract. That is why sexual intercourse is a common risk factor for recurrent infections.
• Pregnant women are also more susceptible to kidney infections due to changes in their urinary tract, as the presence of the baby exerts pressure on the bladder and ureters (tubes that connect the kidneys to the bladder) and hormones.
• People with structural abnormalities in their urinary tract, such as kidney stones or a blockage in the ureter, are also at higher risk of developing kidney infections.
• Weakened immune system from medication, for example, immunosuppression treatment in kidney transplant patients or certain medical conditions like HIV.
• If you have a urinary catheter, you are prone to a bladder infection, from which you can get a kidney infection.
• An enlarged prostate gland slows the urine flow and does not allow the bladder to empty properly, leading to recurrent urinary tract infections. To empty the bladder, you may be prescribed medications. In those men who still do not drain urine well, surgical procedures like transurethral resection of the prostate (TURP), Holium Enucleation of the prostate (HoLeP), ReZUM, or UroLift may be offered.
• A kidney stone increases the risk of urinary tract infection UTI; either the kidney stone itself is the source of bacteria, or it can cause blockage to the ureter. This tube carries urine from the kidney to the bladder. Kidney surgery is necessary to get rid of the stone.
• Anatomical risk factors like spinal cord damage, vesicoureteral reflux, and organ transplant lead to frequent bladder infection and kidney infections as it is easier for bacteria to enter the urinary tract.
  

How would I know I have a kidney infection?

Symptoms of a kidney infection include;

·       Fever

·       Chills

·       Nausea and vomiting

·       Persistent pain in the lower back or side

·       Pain or burning during urination

·       Frequent urination

·       Cloudy or foul-smelling urine

·       Bloody urine

What tests are done to diagnose a kidney infection?

Your NHS Urology Consultant or private urologist will ask about your symptoms and medical history, perform a physical exam, and order tests. These tests may include the following:

Urine tests (urinalysis and urine culture):

Testing for bacteria and white blood cells, nitrites, and blood shows the presence of an infection.

The urine test not only confirms the presence of a urinary system infection but also helps in antibiotic choice, as some bacteria can resist certain antibiotics. Knowledge of the sensitivity of the bacteria helps in antibiotic stewardship and faster resolution of the infection.

Blood test:

Full blood count, renal profile, C Reactive Protein, ESR tests

These blood investigations check for signs of infection, check inflammatory markers and assess kidney function.

Imaging tests:

Ultrasound of kidneys and bladder

It uses sound waves to create images of the kidneys and bladder. It is a non-invasive and painless test that can help detect swelling or abnormalities in the kidneys, such as fluid-filled pockets (abscesses), kidney stones, hydronephrosis (swelling of kidneys), bladder stones, or incomplete bladder emptying.

CT scan:

It uses a combination of X-rays and computer technology to create detailed images of the kidneys and other organs. It can provide more detailed images than ultrasound and helps to detect complications such as kidney abscesses, stones, scarring, or blockages.

Magnetic resonance imaging (MRI)

It uses a magnetic field and radio waves to create detailed images of the kidneys and other organs. It can help detect abnormalities such as growths or cysts and provide information about kidney blood flow.

Nuclear medicine scan:

It involves injecting a small amount of a radioactive substance into the bloodstream, which is then detected as it passes through the kidneys. This test can help detect blockages, and scarring, give information on how much the kidney is working and pick up on other kidney abnormalities.

How can you tell the difference between a kidney infection and a UTI of the bladder?

Kidney infections (pyelonephritis) and UTIs are two types of infections that can affect the urinary tract. While they share some similar symptoms, the two have some key differences.

Symptoms of a UTI typically include:

• Pain or burning during urination
• Frequent urination
• Urgent need to urinate
• Cloudy or strong-smelling urine
• Lower abdominal pain or discomfort
• Blood in urine

Symptoms of a kidney infection may include:

• High fever
• Chills or shaking
• Pain in the back or side
• Nausea or vomiting
• General fatigue or tiredness
• Confusion in older adults

An untreated UTI can potentially spread to the kidneys, leading to a kidney infection. You must seek medical attention if you suspect a UTI or kidney infection symptoms.

Can a kidney infection go away on its own?

In general, waiting for the symptoms of a kidney infection to resolve independently is not recommended, as it can lead to severe complications and serious health problems. Therefore, a kidney infection should always be considered a medical emergency that potentially needs hospital treatment.

Kidney Infection Complications are they serious?

Pyelonephritis can result in complications if left untreated or if the infection is severe. Some of the possible complications of kidney infections include:

1. Sepsis: If the bacteria that cause the kidney infection enter the bloodstream, it can lead to sepsis (blood poisoning), a potentially life-threatening severe infection condition.
2. Chronic kidney disease: Repeated episodes of kidney infection can damage the kidneys, leading to chronic kidney disease (permanent kidney damage).
3. Scarring of the kidneys: Inflammation caused by the infection can result in scarring, impairing kidney function.
4. Abscess: In rare cases, a collection of pus known as an abscess can form in the kidney or surrounding tissue, requiring drainage.
5. High blood pressure: Kidney infection can damage the blood vessels in the kidneys, leading to high blood pressure.
6. Pregnancy complications: Kidney infection can cause problems during pregnancy, including premature delivery and low birth weight.
   

9 Steps in Preventing Kidney Infections.

1. Stay hydrated: Drinking plenty of fluids can help flush bacteria out of your urinary tract, reducing the risk of infection. Use the colour of urine as a benchmark of good hydration.
2. Practice good hygiene: Wipe from front to back after using the toilet, and clean your genitals before and after sex. This helps to prevent bacteria from the anus or vagina from entering the urethra.
3. Urinate frequently: Avoid holding in urine for long periods, as this can lead to bacteria buildup in the bladder. Urinating regularly helps to flush out bacteria from the urinary tract. Emptying the bladder after sexual intercourse may help decrease the chance of an infection.
4. Take care with birth control: Spermicidal foam or diaphragms can increase the risk of bacterial growth, so it's essential to use them correctly. Follow the instructions carefully and use them with other forms of birth control.
5. Avoid irritating feminine products: Douches and powders can irritate, increasing the risk of infection. Avoid using these products and opt for mild, fragrance-free products instead.
6. Treat urinary tract infections promptly: If you develop a urinary tract infection, seek medical treatment to prevent it from progressing to a kidney infection.
7. If you are diabetic, make sure to keep tight control of your sugar levels
8. If you suffer from frequent UTIs, take D-Mannose or Hipprex regularly. These help prevent lower urinary tract infections that can lead to kidney infection (pyelonephritis). One can consider hyaluronic acid bladder instillations. In post menopausal women using oestrogen cream or pessary can help.
9. Address any constipation by drinking plenty of fluids, increasing the dietary intake of fibre, and exercising regularly. If necessary, take laxatives to achieve a regular bowel movement.

Treating kidney infections

The treatment for kidney infections involves antibiotics to kill the bacteria causing the infection. The antibiotic prescribed will depend on the severity of the infection and the type of bacteria causing it.

Sometimes, hospitalisation may be necessary for intravenous antibiotics or if the infection is severe.

Your doctor may also recommend pain relievers or other medications to manage your symptoms.

In addition to antibiotics, there are some self-care measures you can take to help manage your symptoms and promote healing, such as:

Drinking plenty of fluids: Staying hydrated can help flush bacteria out of the urinary tract.

Resting: Resting can help your body heal and conserve energy.

Applying heat to your lower back or abdomen can help relieve pain and discomfort.

How long is the antibiotic treatment for kidney infection?

The course of antibiotics for a kidney infection is usually two weeks.

How soon after treatment for kidney infection will I feel better?

When you have an infection, your immune system is activated to fight off invading pathogens, such as bacteria or viruses. This process requires a lot of energy and resources from your body, leaving you tired.

Fatigue is a common symptom of any infection, and it can range from mild to severe, depending on the severity of the infection.

In the case of a kidney infection, the infection occurs in one or both of the kidneys. The kidneys are responsible for filtering waste products from your blood, and they may not function properly when they are infected. A kidney infection can also cause anaemia, a condition where your body doesn't have enough red blood cells to carry oxygen to your tissues and organs. Anaemia can cause fatigue, weakness, shortness of breath, and other symptoms.

Reflection from a urology specialist

Seek urgent medical attention if you suspect a kidney infection. Taking antibiotics early for acute pyelonephritis avoids serious harm.

Kidney infection treatment can be oral, but if the infection is severe, hospital admission for intravenous antibiotics is needed to prevent blood poisoning and other kidney problems linked to untreated kidney infection.