1. Kidney infection or
pyelonephritis
:Definition 
Pyelonephritis is an infection of the 
. kidney and the urethres
Causes 1- urinary tract infection, in 
the presence of occasional or
persistent back flow
urine from the bladder into the-2 
ureters or kidney pelvis
(. (vesicoureteric reflux

2. Classification of
pyelonephritis
Acute uncomplicated
pyelonephritis sudden
development of kidney
(.inflammation
Chronic pyelonephritis (a long-
standing infection that does not
clear

3. Causes incidence, and risk
factors
The risk is increased if there is a history 
of cystitis, renal papillary necrosis,
kidney stones, vesicoureteric reflux, or
. obstructive uropathy
Acute pyelonephritis can be severe in 
the elderly and in people who are
immunosuppressed (for example, those
(.with cancer or AIDS

4. .
:Symptoms or back pain-
Flank pain
Severe abdominal pain-
.high fever and persists for more than 2 days - 
Chills with shaking.Warm, flushed, moist - 
. skin
. Vomiting, nausea - 
. Fatigue and general ill feeling - 
Painful urination, urinary frequency or urgency -
., nocturia
Cloudy or abnormal urine color, foul or - 
. strong urine odor, and hematuria may occur
Mental changes of confusion - 

5. Diagnostic studies

A urinalysis commonly reveals white- 
blood cells (WBCs) or red blood cells
(. (RBCs
A urine culture may reveal bacteria in- 
. the urine
. A blood culture may show an infection- 
An intravenous pyelogram (IVP) or CT- 
scan of the abdomen may show
enlarged kidneys with poor flow of dye
. through the kidneys

6. Treatment
The goals of treatment are control of 
the infection and reduction of
. symptoms
Acute symptoms usually resolve within 48 to 
. 72 after appropriate treatment
Due to the high mortality rate in the elderly 
population and the risk of permanent kidney
. damage prompt treatment is recommended

7. antibiotics are selected to treat the 
.infection
Intravenous (IV) antibiotics may be used 
initially to control the bacterial infection if
infection is severe a 10- to 14 day course of
antibiotics chronic pyelonephritis
Kidney damage can result from these 
infections. The elederly, infants, and people
with a compromised immune system

so receive frequent monitoring for potential 
problems and to receive IV antibiotics,
additional IV fluids and other medications as
necessary

8. :Complications 
. Recurrence of pyelonephritis 
Perinephric abscess (infection 
(. around the kidney
. Sepsis 
. Acute renal failure 
. Chronic renal failure 


9. prevention
Prompt and complete treatment of 
cystitis pyelonephritis. Chronic or recurrent
.urinary tract infection of the kidneys

Preventive measures may reduce 
symptoms and prevent recurrence of
infection. Keeping the genital area clean and
remembering to from front to back
Urinating immediately after sexual 
intercourse may help eliminate any bacteria

10. Prevention
Increasing the intake of fluids 
to encourage frequent urination that
. flushes bacteria from the bladder
Drinking cranberry juice 
prevents certain types of
bacteria from attaching to the wall
of the bladder

11. Glomerulonephritis is an 
inflammation of the kidney’s filtering
. mechanisms, called the glomeruli
Glomerulonephritis can be acute , 
,which means it occurs suddenly
or chronic , meaning symptoms 
develop gradually and continue over a
number of years

12. common in children between the ages 
.of 2 and 12, particularly boys
Children with frequent streptococcal 
infections
people with diseases such as hepatitis,, or 
.diabetes
What causes it 
occurs after a streptococcal 
infection, such as strep throat-
certain toxins, such as paints
. its cause is not known 

13. What are the signs & 
symptoms
? often flu-like, such as general fatigue,
,nausea, vomiting, loss of appetite, fever
and abdominal and joint pain. These types
of general symptoms can continue for up to
one month before symptoms of kidney
failure appear

14. swelling. They can progress to high blood 
pressure, visual disturbances,
shortness of breath, blood in the
urine, and a reduction in urine
.production

Chronic glomerulonephritis develops so 
gradually that it is often not discovered until
. a routine physical exam
As this condition progresses, it causes high 
blood pressure, swelling, and other
.symptoms of kidney failure

15. How is it diagnosed 
complete medical history, physical - 
. examination, and laboratory tests
check a urine sample for blood and - 
high levels of protein
check for high levels of the waste 
. products creatinine and urea in blood
If a streptococcal infection is suspected, 
throat culture, will reveal this bacteria.
a biopsy, to study under a
microscope. An eye exam may show
signs of vascular changes in people
.with chronic glomerulonephritis

16. the treatment 
bedrest and medications 
to cure any infection, increase urine-1 
, output, and lower blood pressure
to relieve any strain on the kidneys so- 2 
they can recover full function
diet control to your intake of sodium, 
protein, and fluids. Most children recover
, fully

17. no treatment to stop the 
progression of chronic
glomerulonephritis. Once kidney
, failure has occurred
waste products must be removed 
from the bloodstream for the
kidneys through a process called
. dialysis
A kidney transplant may also 
.be an option

18. You can help prevent acute 
glomerulonephritis by treating
streptococcal infections following the
full course of medication
Nursing intervention 
reliefe symtoms &prevention -1 
complication
Diatery intake :protein restriction –-2 
.increase cho
Monitor I &O -vital signs-activity -3 
level-edema-hypertentio
Proternurea &hematuria 
Patient education (medication -4 
,diet,avoidance of trams ,infection
&follow -up

19. Nephrotic syndrome
IS condition marked by very high levels of 
protein in the urine; low levels of protein in
the blood; swelling
of Nephrotic syndrome 
Symptoms of Nephrotic syndrome 
Frothy urine 
Proteinuria 
Low serum protein 
Lipiduria 
Swelling around the eyes 

20. it results from a specific glomerular defect
and indicates renal damage. The prognosis
is highly variable, depending on the
underlying cause. Some forms may
. progress to end-stage renal failure
Causes About 75% of nephrotic syndrome 
cases result from primary (idiopathic)
glomerulonephritis
Some tubules may contain increased lipid -1
deposits
. lesion in patients with adult idiopathic-2 

21. Other causes of nephrotic 
metabolic diseases such as -1 
; diabetes mellitus
collagen-vascular disorders, such 
as 2 -systemic lupus
erythematosus and polyarteritis
circulatory diseases, such as -3 
heart failure and sickle cell
anemia; 4- nephrotoxins, such as
mercury, gold, and nonsteroidal 5-
anti-inflammatories; allergic
reactions; infections, such as

22. Diagnosis 
Consistent proteinuria in excess of 3.5 
; g/24 hours strongly suggests syndrome
examination of urine reveals an 
increased number of granular, and waxy,
. fatty casts, and oval fat bodies
Serum values that support the diagnosis 
are increased cholesterol, phospholipid, and
triglyceride levels and decreased albumin
. levels
Histologic identification of the lesion 
requires a kidney biopsy

23. Treatment 
.correction of the underlying cause- 1 
Supportive treatment consists of-2 
protein replacement with a nutritional diet of
1 g protein/kg of body weight, with restricted
.sodium intake
a diuretic for edema; and an antibiotic-3 
. for infection
Immunosuppressants ,-4 
. antihypertensives, and diuretics
Angiotension-converting enzyme -5 
inhibitors can decrease protein loss in urine

24. Nursing intervention