Chronic pyelonephritis

Chronic pyelonephritis is most commonly caused by chronic vesicoureteral reflux.

Diagnosis is clinical and confirmed with imaging studies. Typically, a biopsy is not performed.

There is no specific treatment, as damage is irreversible.

May result in end-stage renal disease.

Pyelonephritis - from the Greek "pyelo" (pelvis), "nephros" (kidney), and "itis" (inflammation) refers to an inflammation - of the kidney that can be acute, recurrent, or chronic. Chronic pyelonephritis is a complex renal disorder characterised by chronic tubulointerstitial inflammation and deep segmental cortical renal scarring and clubbing of the pelvic calyces as the papillae retract into the scars. It is an important cause of end-stage renal disease.

The term chronic pyelonephritis is sometimes used synonymously with interstitial nephritis, reflux nephropathy, and chronic atrophic pyelonephritis, and encompasses relatively rare but severe variants such as xanthogranulomatous pyelonephritis and emphysematous pyelonephritis.[1]Huang JJ, Tseng CC. Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med. 2000 Mar 27;160(6):797-805. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485260 http://www.ncbi.nlm.nih.gov/pubmed/10737279?tool=bestpractice.com