Pyelonephritis :: Nationwide Children's Hospital


What is pyelonephritis?

Pyelonephritis is the medical term for a kidney infection. The most common cause of acute kidney infections in children is from a bacterial urinary tract infection (UTI) that has spread from the bladder to the kidneys. The bacteria trigger inflammation and the kidneys respond by producing more urine, which leads to dehydration.

The inflammation and dehydration from just one kidney infection can result in scarring that can cause high blood pressure and reduced kidney function. Therefore, it is critical that children who have a UTI and fever, especially those under the age of 2, receive prompt medical care to prevent possible permanent kidney damage. Repeat acute kidney infections can ultimately lead to the need for a kidney transplant. In very rare cases, untreated pyelonephritis can cause death.

How do the kidneys become infected?

Acute kidney infections are typically caused by bacteria that has gotten into the urethra (the opening where urine comes out) and traveled up through the bladder and ureters (the tubes that carry urine from the kidneys to the bladder). Some medical conditions such as bladder dysfunction, bladder obstruction, neurogenic bladder or vesicoureteral reflux (VUR) along with conditions that require the use of catheters can also increase the chances of kidney infection and damage.

What are the symptoms of an acute kidney infection?

Signs and symptoms vary with age:

  • Newborns: no fever but poor feeding and vomiting
  • Children <2: may have a fever (but not always), a poor appetite, vomiting and diarrhea
  • Children >2:  fever, appetite changes, stomach or lower back pain, symptoms of urgency, frequency and pain with urination

If a toilet trained child is having accidents during the day or night, it may be a sign of an infection.  Typically a child’s urine will have a strong, foul odor, and there may be blood in the urine. 

How is an acute kidney infection diagnosed?

A simple urine test combined with an overview of the symptoms is usually enough to confirm a kidney infection. If you have a child that keeps getting UTIs with fevers, physicians may recommend an ultrasound of the kidneys that can help identify any underlying issues.

How are acute kidney infections treated?

Children are typically given oral antibiotics to take at home. However, if the infection is advanced, a child may receive intravenous (IV) antibiotics in the hospital. Staying well hydrated is an extremely important part of treatment, and children should drink plenty of fluids during and after treatment. There is evidence that good hydration during recovery may help reduce long-term kidney damage.

What can I do to help prevent my child from getting a kidney infection? 

If you suspect your child has a UTI, get them prompt medical treatment to help prevent the UTI from turning into a kidney infection. Here are some tips for preventing UTIs.

While preventative antibiotics have been found to reduce the number of recurrent UTIs, there isn’t any evidence that their use decreases the risk of kidney infection or scarring. Uncircumcised boys that are less than one year old are ten times more likely to get UTIs than circumcised boys, but by age two the risk decreases and circumcision does not have an effect on infection rates.

When should I take my child to a Pediatric Urologist?

A referral to a Pediatric Urologist is recommended if an ultrasound reveals any abnormalities in kidney function or appearance.

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700 Children's Drive Columbus, Ohio 43205 614.722.2000