Pathophysiology – UTI t/c Pyelonephritis

Theoretical

Predisposing Factors Precipitating Factors

 Immunosuppression*  Diabetes mellitus*

 Instrumentation of the  Pregnancy*
urinary tract*  Age
 Kidney stones  Gender
 Urinary retention*

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
 Introduction of
bacteria to the ureter

Inflammation of the
ureter

Ureteritis

Infection ascends to
the kidneys

Pyelonephritis

Activation of the General feeling of Nausea/Vomiting*

immune response being unwell

Release of pyrogens Malaise

from bacteria
Dysuria

Release of
prostaglandin E2 Flank pain*

Elevation of the body

thermostat by the Decreased
hypothalamus erythropoietin
production

Vasoconstriction Reduced heat loss

through the skin Decrease stimulation
of the bone marrows
Shivering
Chills
Decreased
Fever erythropoiesis

Decreased RBC
production

Anemia