Renal Infections and Diseases: Pyelonephritis, CKD, and Glomerulonephritis

Pyelonephritis - Definition

Inflammation of the renal parenchyma and urinary collecting system, usually caused by bacterial infection.

Pyelonephritis - Most Common Cause

Escherichia coli (E. coli).

Pyelonephritis - Risk Factors

Multiple untreated UTIs, vesicoureteral reflux, urinary obstruction (BPH, stones), catheters, pregnancy, sexual activity.

Pyelonephritis - Clinical Manifestations

Fever, chills, flank pain, nausea/vomiting, dysuria, urgency, hematuria, costovertebral tenderness.

Pyelonephritis - Diagnostics

Urinalysis (pyuria, bacteriuria, hematuria), urine culture, CBC (leukocytosis), CT/ultrasound if obstruction suspected.

Pyelonephritis - Treatment

IV or oral antibiotics (fluoroquinolones, Bactrim), hydration, pain control, antipyretics, urinary analgesics (Pyridium).

Pyelonephritis - Complications

Chronic kidney disease, renal scarring, abscess formation, urosepsis.

Pyelonephritis - Nursing Interventions

Monitor vitals, pain, urine output; administer antibiotics; encourage fluids; provide teaching on prevention.

Pyelonephritis - Patient Teaching

Complete antibiotics, practice good hygiene, increase fluids, void after intercourse, avoid irritants, recognize early UTI symptoms.

Chronic Kidney Disease - Definition

Progressive, irreversible loss of kidney function lasting more than 3 months.

Chronic Kidney Disease - Major Causes

Diabetes mellitus, hypertension, glomerulonephritis, polycystic kidney disease.

Chronic Kidney Disease - Pathophysiology

Nephrons are destroyed, GFR decreases, toxins accumulate, leading to uremia and systemic complications.

Chronic Kidney Disease - Clinical Manifestations

Fatigue, edema, hypertension, anemia, electrolyte imbalances, decreased urine output, uremic frost.

Chronic Kidney Disease - Diagnostics

Elevated BUN and creatinine, decreased GFR, electrolyte abnormalities, proteinuria, imaging shows small kidneys.

Chronic Kidney Disease - Treatment

Manage underlying cause, control BP, restrict protein, dialysis, kidney transplant.

Chronic Kidney Disease - Nursing Interventions

Monitor labs, fluid balance, blood pressure, provide renal diet education, prepare for dialysis if needed.

Chronic Kidney Disease - Patient Teaching

Limit sodium, potassium, and protein intake, take medications as prescribed, avoid nephrotoxic substances.

Glomerulonephritis - Definition

Inflammation of the glomeruli of the kidney caused by immune reactions or infection.

Glomerulonephritis - Causes

Post-streptococcal infection, autoimmune diseases (lupus, Goodpasture's), vasculitis.

Glomerulonephritis - Pathophysiology

Antibodies and complement deposit along the glomerular basement membrane, leading to inflammation and decreased filtration.

Glomerulonephritis - Clinical Manifestations

Hematuria, proteinuria, edema (especially periorbital), hypertension, oliguria, flank pain.

Glomerulonephritis - Diagnostics

Urinalysis (RBCs, WBCs, protein), elevated BUN/creatinine, decreased complement, history of strep infection.

Glomerulonephritis - Treatment

Antibiotics (penicillin for strep), diuretics, antihypertensives, sodium/fluid restriction, corticosteroids, plasmapheresis, rest.

Glomerulonephritis - Complications

Chronic kidney disease, renal failure, nephrotic syndrome, hypertension.

Glomerulonephritis - Nursing Interventions

Monitor vitals, daily weights, I&O, assess edema, administer medications, restrict fluids/sodium, educate on diet and rest.

Glomerulonephritis - Patient Teaching

Explain disease process, importance of medication adherence, infection prevention, and dietary restrictions.