Pyelonephritis

Pyelonephritis means you have an infection of the inner wall of your renal pelvis. Your renal pelvis is at the bottom of your kidneys. The kidneys produce urine, which is collected in the renal pelvis. Urine then passes from the renal pelvis through the ureters to the bladder. The infection is caused by bacteria. These are often the same bacteria which live in the gut. These bacteria eventually reach your renal pelvis through the urethra. The bacteria stick to your renal pelvis, causing an infection.

Some people are more likely to get pyelonephritis. These people are:

• Pregnant women
• Young children
• Men
• People with a compromised immune system (for example due to diabetes or medication)
• People with kidney stones or bladder stones
• People with a catheter (tube) in the bladder

The symptoms of pyelonephritis are very similar to the symptoms of a bladder infection. However, the symptoms are often more severe with pyelonephritis. Symptoms you may experience include:

• Pain when urinating
• Urinating little and often
• Strong, often foul-smelling urine
• Cloudy urine
• Blood in urine
• A high fever
• Shivers
• Nausea
• Pain in your back or side (on 1 or both sides)
• Confusion in the elderly

You can reduce your pyelonephritis symptoms and combat the infection more quickly. In case of pyelonephritis, we recommend you:

• Drink plenty. The guideline for this is 2 to 3 litres of fluid per day. This can be, for example, water, but also tea.
• Go to the toilet immediately if you feel like you need to urinate
• Empty your bladder completely when you go to the toilet. This means it will be less likely that bacteria will remain in your bladder which can then travel to the renal pelvis.
• If you’re nauseous or vomiting: drink small amounts of water instead of a whole glass at once. This will allow you to keep the water in more effectively.

You should contact your GP or the out-of-hours service if you think you have pyelonephritis. You should also contact your GP or the out-of-hours service if you have pyelonephritis and one or more of the following situations applies to you:

• Measured fever (38 degrees or above) after taking antibiotics for 2 days. Measure the temperature via the anus
• Your symptoms haven’t lessened after taking antibiotics for 2 days
• You’re becoming more unwell
• Your pain is getting worse
• You’re getting confused (delirious)

There’s a chance the antibiotics aren’t working if you’re taking antibiotics and any of these apply to you. This means the antibiotics aren’t working against the bacteria which is causing the infection. Your GP will then assess whether you need a different type of antibiotic.

Please also contact your GP or the out-of-hours service if you can’t keep the antibiotics down because you’re vomiting, for example.

If you’re not sure whether you should go to your GP, fill in the digital self-triage immediately and we will provide you with instant advice!