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Highlights & Basics
- Chronic pyelonephritis is most commonly caused by chronic vesicoureteral reflux.
- Diagnosis is clinical and confirmed with imaging studies. Typically, a biopsy is not performed.
- There is no specific treatment, as damage is irreversible.
- May result in end-stage renal disease.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Chronic pyelonephritis: tubular damage, interstitial scarring, and fibrosis in chronic pyelonephritis
Medium-power microscopic view of dense polymorphonuclear infiltrates, showing chronic tubular atrophy, glomerulosclerosis, and surrounding areas of normal tubules and glomeruli
High-power view of polymorphonuclear cells in the renal tubules, showing damage to the tubules and red blood cell infiltration in the interstitial spaces
Xanthogranulomatous pyelonephritis: very low-power microscopic view showing extensive cellular infiltrate and granulomas. Note the marked destruction of the normal renal architecture
H&E stain: high-power view of granulomas found in xanthogranulomatous pyelonephritis
Very high-power view of xanthoma cells, which are lipid-filled macrophages
Citations
Vourganti S, Agarwal PK, Bodner DR, et al. Ultrasonographic evaluation of renal infections. Radiol Clin North Am. 2006 Nov;44(6):763-75.[Abstract]
European Association of Urology. Urological infections. 2023 [internet publication].[Full Text]
Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20.[Abstract][Full Text]
American Urological Association. Management and screening of primary vesicoureteral reflux in children (2010, amended 2017). 2021 [internet publication].[Full Text]
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