Pyelonephritis is a bacterial infection involving the kidney and upper urinary tract, resulting in inflammation of renal tissue and potential impairment of kidney function. It is a common condition treated in nephrology and internal medicine practice in the UAE, particularly among women, elderly individuals, and patients with underlying urinary tract abnormalities or chronic diseases such as diabetes.

The infection usually ascends from the lower urinary tract to the kidneys. Common causative organisms enter the urinary system and proliferate within renal tissue, triggering an inflammatory response. Risk factors include urinary obstruction, kidney stones, vesicoureteral reflux, pregnancy, catheter use, and compromised immunity. If untreated, pyelonephritis may progress to sepsis, acute kidney injury, or permanent renal scarring.

Patients typically present with fever, chills, flank or back pain, nausea, vomiting, and urinary symptoms such as burning or increased frequency of urination. In severe cases, patients may develop confusion, low blood pressure, or reduced urine output. Laboratory evaluation often reveals elevated inflammatory markers, abnormal urine findings, and, in complicated cases, impaired kidney function.

Diagnosis is based on clinical presentation supported by urine analysis, urine culture, and blood tests. Imaging studies such as ultrasound or CT scan may be required in recurrent or complicated cases to identify obstruction, abscess formation, or structural abnormalities.

Management involves prompt antibiotic therapy, tailored to culture results when available, along with adequate hydration and supportive care. Hospitalization may be required for severe infections, pregnancy, or patients with significant comorbidities. Early treatment usually results in complete recovery, while delayed or recurrent infections increase the risk of chronic kidney disease.
Long-term management focuses on identifying and correcting underlying risk factors to prevent recurrence. Patients with repeated episodes require nephrology or urology evaluation to protect kidney health and prevent long-term complications.