Inflammation of the kidneys is called nephritis. When nephritis is caused by an infection, it is usually the result of a spread upwards from the bladder, resulting in pyelonephritis (inflammation of the ureters and the kidneys). Infection occasion ally reaches the kidneys from the bloodstream. Pyelonephritis is more common in women than in men, particularly during pregnancy.
Urinary tract infection is more likely if there is anything interfering with the free flow of urine from the kidneys to the outside: for example, congenital abnormal ties of the urinary system; kidney, ureter or bladder stones; tumours or any other obstruction to the bladder outlet; anything that presses on the drainage system from outside, such as the pregnant uterus or a tumour in the abdomen. Foreign bodies (such as a catheter) in the bladder can introduce infection.
If you suspect pyelonephritis, see your doctor without delay. Prompt treatment is very important to prevent destruction of kidney tissue, which could result in kidney failure or septicaemia. Antibiotics are usually started as soon as a urine specimen has been taken to see which germ is causing the infection and which antibiotics will kill it. When the laboratory results are available (usually after 48 hours), your doctor will tell you whether you’re taking the right antibiotic. Your urine must be checked after treatment to be sure that the infection has completely cleared. If the source of the infection isn’t obvious, your doctor will suggest tests so that the cause can be found and treated to prevent future attacks.
Not all nephritis is caused by infection: the kidneys can become inflamed by some poisons and drugs, and by auto-immune reactions. Non-infectious nephritis is also serious and can lead to kidney failure if it’s not treated. The symptoms and signs of non-infectious nephritis may be much less dramatic, and include reduced urine output, smoky grey urine, puffiness of the face, swelling of the hands and feet, fatigue, and maybe slight fever and mild pain in the loins. Your doctor will always suggest urine and blood tests to check for nephritis if you have any such symptoms with no other obvious cause.
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