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Pyelonephritis affects about 1 to 2 per 1,000 women each year and just under 0.5 per 1,000 males. [ 5 ] [ 7 ] Young adult females are most often affected, followed by the very young and old. [ 2 ] With treatment, outcomes are generally good in young adults.
Pyelonephritis occurs between 20 and 30 times less frequently. [4] They are the most common cause of hospital-acquired infections accounting for approximately 40%. [115] Rates of asymptomatic bacteria in the urine increase with age from two to seven percent in women of child-bearing age to as high as 50% in elderly women in care homes. [42]
Clinical symptoms in patients with pyonephrosis can range from frank sepsis (15%) to asymptomatic bacteriuria. Upon physical examination, the hydronephrotic kidney may be linked to a palpable abdominal mass . [ 4 ]
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
In women, approximately 12–13 in 10,000 cases are treated as outpatients and 3-4 cases are admitted to a hospital. [16] The most common age group affected by Xanthogranulomatous pyelonephritis is middle-aged women. [17] Infants and elderly are also at an increased risk because of hormonal and anatomical changes. [18]
Nephritis can often be caused by infections and toxins, but it is most commonly caused by autoimmune disorders that affect the major organs like kidneys. [5]Pyelonephritis is inflammation that results from a urinary tract infection that reaches the renal pelvis of the kidney.
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This constellation of symptoms contrasts with the classical presentation of nephrotic syndrome (excessive proteinuria >3.5 g/day, low plasma albumin levels (hypoalbuminemia) <3 g/L, generalized edema, and hyperlipidemia). [8] [10] Signs and symptoms that are consistent with nephritic syndrome include: Hematuria (red blood cells in the urine) [11]