Chronic pyelonephritis is a disease defined by scarring and atrophy of the kidneys. This condition is different from the acute pyelonephritis in which the bacterial infection of the kidney causes the symptoms. Acute pyelonephritis is actually an ascending urinary tract infection that has reached the kidneys. Chronic pyelonephritis is, in contrast, defined as a medical condition that develops over time due to some kind of damage to the kidney tissue. In most of the cases, infection is the key reason behind this damage but underlying disorder can also involve a structural or functional abnormalities in the urinary tract. This actually means that certain individuals may be more prone to kidney infections and that their kidneys may one day start working with a decreased functional ability.
Causes of chronic pyelonephritis
As already mentioned, the risk of chronic pyelonephritis is high in patients with repeated urinary tract infections. These are usually persons affected with diabetes, kidney stones, urinary tract obstructions, or people who use certain analgesics. However, this condition sometimes develops regardless of any kind of infection. People with abnormal junction between the ureter and bladder in childhood may develop it. This congenital condition allows urine to flow backward from the bladder to the ureter and up into the kidney. This reflux can gradually lead to kidney scaring. Other risk factors associated with development of this disease are persistent high blood pressure, being a woman, and being white.
Prognosis for chronic pyelonephritis
Chronic pyelonephritis is diagnosed in 4 out of 1,000 asymptomatic adults. In children with urinary tract infections, prevalence of chronic pyelonephritis is as much as 40% to 50%. If a treatment starts on time the prognosis is quite good since the disease is not allowed to progress to more advanced stage that involves a renal failure. Patients with only one kidney affected generally have normal life expectancy. People with both kidneys affected may have slightly reduced life span. Complications associated with this disease include recurrent kidney infections with resistant bacteria and possibility of continued kidney damage.
Treatment for chronic pyelonephritis
The exact treatment depends on the underlying cause. If some kind of urinary tract infection causes the condition, doctors will probably prescribe antibiotic therapy. If there are some underlying structural abnormalities they may be corrected by surgery. Surgery is also used to remove any kind of obstruction such as kidney stones. Treatment for vesicoureteral reflux involves repair of congenital structural abnormalities. In some cases doctors may even recommend removal of the kidney.