Pathophysiology UTI t/c Pyelonephritis

Theoretical

Predisposing Factors

Immunosuppression*
Instrumentation of
urinary tract*
Kidney stones
Urinary retention*

Precipitating Factors

the

Attachment of bacteria
to the urethra

Proliferation of
bacteria in the urethra

Urethritis

Urethrovesical reflux

Introduction of
bacteria into the
bladder

Proliferation of
bacteria in the bladder

Inflammation of the
bladder

Cystitis

Ureterovesical reflux

Diabetes mellitus*
Pregnancy*
Age
Gender

Introduction of
bacteria to the ureter

Inflammation of the
ureter

Ureteritis

Infection ascends to
the kidneys

Pyelonephritis

Activation of the
immune response

General feeling of
being unwell

Release of pyrogens
from bacteria

Malaise
Dysuria

Release of
prostaglandin E2

Flank pain*

Elevation of the body

thermostat by the
hypothalamus
Vasoconstriction

Nausea/Vomiting*

Decreased
erythropoietin
production
Reduced heat loss
through the skin

Decrease stimulation
of the bone marrows

Shivering
Chills
Fever

Decreased
erythropoiesis
Decreased RBC
production
Anemia