Glomerulonephritis vs Pyelonephritis

Nursing Students Student Assist Nursing Q/A

I'm in my adults rotation and during our lecture today, were were differentiating between "glomerulonephritis, and pyelonephritis." We need to know what each is (pathophysiology) , risks factors/causes, acute/chronic symptons, diagnosis, and interventions for both. There is an overwhelming amout of information relating to these two that our instructor has given us. Each of these kidney disorders has an overwhelming amount of info. for all of the above facts we need to know about these 2. Does anyone have any suggestions on how to study for this? There is some overlapping in terms of diagnosis/interventions/acute and chronic symptoms. I guess I'm just trying to figure out how NOT to confuse the 2.

Thanks for your time,

Brandon

3 Answers

Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.

I use to associate pyelonephritis with utis, since it usually starts from the bottom up moving to the kidneys, also with back flow bringing "Dirty studd up the clean tubes". This could be chronic, like from reoccurring uti, (specially with the elderly and immobile patients) or acute which happens suddenly from a kidney inflammation, anything that got in the way of the pyelo like a stone or such that caused the problem, diabetes can play a role on both of this processes here, since bacteria loves sugar so recurrent uti are not uncommon.

Now when it comes to glomerulonephritis, its a totally different issue since the cause is unknown, it could be from the person being diabetic and the little vessels on the kidney messing up not providing well to some of the grapes (gromerulos) so then the other "Grapes" swell up trying to work harder to make up for those who are not working (acting just like COPD does to alveoli on the lungs) the end product is a not well filtered urine causing the the person to be sob and edematious since the fluids are not being filtered the way they should, the urine becomes foamy, and tea like colored... This could be chronic (dm, infections that found their way to the kidneys, such as strep or that other one that causes pericarditis.) or acute, such as trauma, or taking a hit on the back, mva things that would affect the kidney all of a sudden.

Pyelonephritis is an infection of the kidney and the ureters, the ducts that carry urine away from the kidney.

  • Back pain orflank pain
  • Chills with shaking
  • Severe abdominal pain (occurs occasionally)
  • Fatigue
  • Fever
  • General ill feeling
  • Chills with shaking
  • Mental changes or confusion*
  • Skin changes
  • Urination problems
  • Vomiting, nausea
  • Higher than 102 degrees fahrenheit
  • Persists for more than 2 days
  • Flushed or reddened skin
  • Moist skin (diaphoresis)
  • Warm skin
  • Blood in the urine
  • Cloudy or abnormal urine color
  • Foul or strong urine odor
  • Increased urinary frequency or urgency
  • Need to urinate at night (nocturia)
  • Painful urination
  • * mental changes or confusion may be the only signs of a urinary tract infection in the elderly.

The goals of treatment are to:

  • Control the infection
  • Relieve symptoms
  • Causes

Pyelonephritis most often occurs as a result of urinary tract infection, particularly when there is occasional or persistent backflow of urine from the bladder into the ureters or an area called the kidney pelvis. See: vesicoureteric reflux

Pyelonephritis can be sudden (acute) or long-term (chronic).

Acute uncomplicated pyelonephritis is the sudden development of kidney inflammation.
Chronic pyelonephritis is a long-standing infection that does not go away.

Pyelonephritis occurs much less often than a bladder infection, although a history of such an infection increases your risk. You're also at increased risk for a kidney infection if you have any of the following conditions:

  • Backflow of urine into the ureters or kidney pelvis
  • Kidney stones
  • Ostructive uropathy
  • Renal papillary necrosis

You are also more likely to get a kidney infection if you have a history of chronic or recurrent urinary tract infection, especially if the infection is caused by a particularly aggressive type of bacteria.

Acute pyelonephritis can be severe in the elderly and in people who are immunosuppressed (for example, those with cancer or aids).

Tests & diagnosis

Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged.

Common symptoms of glomerulonephritis are:

  • Blood in the urine (dark, rust-colored, or brown urine)
  • Foamy urine
  • Swelling (edema) of the face, eyes, ankles, feet, legs, or abdomen

Symptoms that may also appear include the following:

  • Abdominal pain
  • Cough
  • Diarrhea
  • General ill feeling
  • Fever
  • Joint aches
  • Muscle aches
  • Loss of appetite
  • Shortness of breath
  • Cgn (chronic renal failure)symptoms may gradually develop.

Other symptoms that may occur with this disease:

  • Excessive urination
  • Nosebleed
  • Blood in the vomit or in stools

Treatment varies depending on the cause of the disorder, and the type and severity of symptoms. High blood pressure may be difficult to control, and it is generally the most important aspect of treatment.

Medicines that may be prescribed include:

Blood pressure medications are often needed to control high blood pressure. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are most commonly prescribed.
Corticosteroids may relieve symptoms in some cases.
Medications that suppress the immune system may also be prescribed, depending on the cause of the condition.
A procedure called plasmapheresis may be used for some cases of glomerulonephritis due to immune-related causes. The fluid part of the blood containing antibodies is removed and replaced with intravenous fluids or donated plasma (without antibodies). Removing antibodies may reduce inflammation in the kidney tissues.

Dietary restrictions on salt, fluids, protein, and other substances may be recommended.

Persons with this condition should be closely watched for signs that they are developing kidney failure. Dialysis or a kidney transplant may eventually be necessary.

Causes

Glomerulonephritis may be caused by specific problems with the body's immune system. Often, the precise cause of glomerulonephritis is unknown.

Damage to the glomeruli causes blood and protein to be lost in the urine.

The condition may develop quickly, with loss of kidney function occurring over weeks and months (called rapidly progressive glomerulonephritis).

In about a quarter of people with chronic glomerulonephritis there is no history of kidney disease and the disorder first appears as chronic renal failure.

The following increase your risk of developing this condition:

  • History of cancer
  • Blood or lymphatic system disorders
  • Exposure to hydrocarbon solvents
  • Infections such as strep infections, viruses, heart infections,or abscesses
  • Diabetes

Many conditions are known to cause or increase the risk for glomerulonephritis, including:

  • Focal segmental glomerulosclerosis
  • Goodpasture syndrome
  • Membranoproliferative gn
  • Iga nephropathy
  • Lupus nephritis or henoch-schonlein purpura
  • Anti-glomerular basement membrane antibody disease
  • Blood vessel diseases such as vasculitis or polyarteritis
  • Amyloidosis
  • Tests & diagnosis

I suggest dividing a sheet of paper in half and then having glomerulonephritis on one side and pyelonephritis on the other and writing their information and comparing it side by side...

Specializes in Cardiac, Rehab.

Perfect answer to the same question I had. Thanks

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