Inpatient Treatment of Pyelonephritis: When Hospitalization is Necessary and How is Treatment Administered?
Pyelonephritis is an inflammation of the kidneys, affecting the renal pelvis, calyces, and parenchyma. The insidious nature of this disease lies in its rapid progression: yesterday you simply had lower back pain, and today you have a fever.
Inpatient treatment for pyelonephritis is best. There, the cause of the inflammation can be quickly identified, the antibiotic that works, and the source of infection can be completely eliminated.
A comprehensive inpatient approach reduces treatment time by half compared to outpatient treatment.
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Not every kidney inflammation requires hospitalization, but there are clear indications for hospitalization, which, if ignored, can be life-threatening. The doctor will insist on in-office treatment if outpatient care is ineffective or the patient's condition is assessed as moderate.
You should go to the hospital if you have:
- High fever that can't be reduced with medication
- Nausea, vomiting, severe weakness
- Severe lower back pain that can't be relieved with medications from your home medicine cabinet
- Obstructed urine flow (obstructive pyelonephritis)
- Abnormal test results for pyelonephritis: pus in the urine or high white blood cell counts
Urgent care is needed for people with diabetes, the elderly, and pregnant women.
Acute pyelonephritis is quickly treated in hospital, provided it is not caused by a ureteral obstruction.
Stages of diagnostics in the emergency room and department
Upon admission, the patient is first examined by a urologist or nephrologist. A thorough history and examination are conducted. Laboratory and instrumental diagnostics are key.
Not all stones are visible on ultrasound, so if the patient's condition does not improve, a CT scan is performed.
When registering for hospitalization:
- They take blood and urine samples
- They do a urine culture and test the sensitivity of the bacteria found to antibiotics
- They perform an ultrasound to check for stones
Treatment methods in a hospital setting
The department uses complex therapy aimed at eliminating infection, reducing inflammation, and cleansing the body of toxins.
Antibacterial and Detoxification Therapy
The basis of treatment is a course of intravenous antibiotics. In hospitals, modern broad-spectrum medications are used: third- and fourth-generation cephalosporins, as well as fluoroquinolones. After receiving urine culture results, the doctor can adjust the therapy, selecting the most effective, specialized antibiotic.
Infusion therapy is administered concurrently. Intravenous saline solutions help flush the kidneys, reduce the concentration of bacterial toxins in the blood, and eliminate dehydration. Additionally, uroseptics are prescribed—medications that accumulate in the urinary tract and enhance the effect of antibiotics.
Pain relief and restoration of urine flow
Anspasmodics and nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain relief. If the inflammation is caused by a urinary obstruction (for example, a stone blocking the ureter), bladder catheterization or placement of a special stent in the ureter to drain the kidney may be necessary.
Diet and Fluid Regimen (Diet No. 7)
Diet plays an important role in kidney inflammation. In hospitals, Diet No. 7 is used. Its main principles are:
- Minimal salt intake (up to 2-3 grams per day)
- No spicy, salty, or smoked foods
- Protein restriction during the acute phase
As surprising as it may sound, with kidney disease you need to drink more: up to 2-2.5 liters of water, cranberry, or lingonberry juice. However, this is possible as long as there is no urinary retention or swelling.
Possible complications if you refuse hospitalization
Treating at home without a diagnosis can have serious consequences, such as:
- Paranephritis: inflammation progresses to cancer
- Abscess or carbuncle of the kidney: pus that can lead to kidney loss
- Urosepsis: bacteria enter the bloodstream, which poses a threat to the entire body
Taking antibiotics haphazardly can lead to chronic illness: pain will return repeatedly when exposed to cold. Ultimately, the kidney may deteriorate, leading to kidney removal.
Frequently Asked Questions
Can pyelonephritis be cured without antibiotics?
Is a diet necessary after discharge?
How do you know if the treatment is working?
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Advantages of inpatient treatment over home treatment
Many patients choose to be treated at home, underestimating the risks. However, kidney treatment in a hospital is fundamentally different in the quality and speed of care.
Advantages of inpatient care:
The inpatient environment is calmer. You don't have to worry about work, everyday problems, or look for an appointment with a doctor.