Pyelonephritis: In- and Outpatients

Acute pyelonephritis, an inflammation of the kidney due to bacterial infection, can become complicated when various risk factors are present. These factors include age above 65, diabetes, urinary tract abnormalities, pregnancy, immunosuppression, antibiotic-resistant bacteria, hospital-acquired infections, extended symptom duration, catheters or stents, and male gender. This condition, particularly obstructive pyelonephritis, carries a significant risk of progressing to sepsis and even death if left untreated. Although more common in women, it also affects men, children, and pregnant women, albeit to a lesser extent. Globally, acute pyelonephritis is estimated to occur in 10.5–25.9 million cases, with up to 1,138,000 cases in the USA alone. Hospitalization rates range from 9 to 12 per 10,000 for women and 1 to 3 per 10,000 for men, with higher mortality in males (1.6 vs. 0.7%). The economic burden of this condition in the USA is substantial, estimated at approximately $2.14 billion. Age is a critical determinant of the disease’s impact. These findings underscore the significant public health and economic implications of acute pyelonephritis.