Epidemiology

Chronic pyelonephritis occurs in both adults and children but is more common in children. It is more common in white people than in black people, and affects women more often than men.

The true incidence of vesicoureteral reflux (VUR) is less than 1%, but is higher among high-risk individuals: for example, siblings with reflux.[2][3]​ Obstructive anomalies are found in up to 4% of children presenting with first episode of urinary tract infection (UTI).[4]

The incidence of renal scars in children with VUR is variable (30% to 70%), and is likely to be due to a variety of diagnostic modalities.[3]​[5]​​

Boys are more likely to have congenital renal dysplasia associated with more severe VUR, whereas girls are more likely to have acquired focal renal scarring from UTIs.[6]​ The emphasis placed on early diagnosis of VUR and UTIs since the 1970s may have reduced the incidence of acquired renal damage, and hence its impact on the development of chronic pyelonephritis and other forms of chronic kidney disease in recent years.[7]

Xanthogranulomatous pyelonephritis, a severe, atypical, and relatively rare form of chronic pyelonephritis, accounts for 0.6% of surgically confirmed cases of chronic pyelonephritis.[8][9]​​ Women (most often with diabetes mellitus and in their 60s and 70s) are affected more often than men.[8] The disease rarely occurs in children.[10] Emphysematous pyelonephritis, another severe form of chronic pyelonephritis, is seen predominantly in people with poorly controlled diabetes mellitus.

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