Can acute pyelonephritis (kidney infection) cause acute renal failure (ARF)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Rarely, acute pyelonephritis can cause acute kidney injury (AKI) in children, healthy adults, and pregnant women. When this occurs, characteristically, recovery proceeds more slowly than with AKI from other causes. In most instances, other factors are thought to contribute to the AKI (eg, medications, hypovolemia, obstruction, sepsis). In a retrospective review of 403 adult patients hospitalized for acute pyelonephritis, multivariate analysis showed that age over 65, complicated or bilateral pyelonephritis, and initial shock were independent risk factors for the occurrence of AKI. [10]

A Danish population-based cohort study of 8760 patients found that preadmission impaired kidney function is a strong risk factor for development of AKI in patients with pyelonephritis. The 30-day risk of AKI rose steadily from 16% in patients with a preadmission estimated glomerular filtration ration (eGFR) ≥90 mL/min/1.73 m2 to 47% for patients with preadmission eGFR of < 30. [11]


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