Pyelonephritis

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Urgent 

See a GP if you feel feverish and have pain that will not go away in your tummy, lower back or genitals. You should also see a GP if you have symptoms of a Urinary Tract Infection (UTI) that have not improved after a few days, or if you have blood in your urine. 

If you cannot get a GP appointment and need urgent medical attention, go to your nearest Urgent Treatment Centre (UTC) / Urgent Care Centre (UCC). Alternatively, go to your nearest A&E department.

If you have recurrent UTI (lower or upper), you should see your GP to discuss this, even if you have been to the hospital, Walk in Centre or Urgent Care clinics for treatment for them. If you're male, you should see your GP the first time you experience any UTI symptoms and, as above, attend A&E if you cannot secure an on the day appointment. 

•  Symptoms of Sepsis (click here for more information)
• If you have symptoms of pyelonephritis and cannot secure a same-day GP appointment
• If you are pregnant
• If you are dehydrated or unable to tolerate oral fluids or medication
• If you have a known or suspected structural or functional abnormality of the genitourinary tract
• If you have an underlying condition such as diabetes mellitus or immunosuppression
• If your symptoms persist or worsen despite antibiotic treatment
• If you feel severely unwell

If you experience any of these symptoms, go to the nearest Emergency Department as quickly and safely as possible. You may need to call 999 for an ambulance or consider alternative transport options, such as asking a friend or relative, or using a taxi or ride-sharing service.

Please note: Arriving by ambulance does not guarantee you will be seen sooner. All patients are assessed on arrival, and treatment is prioritized based on the urgency of their symptoms.

The main symptoms of Pyelonephritis are...

• Pain in the mid/lower back or one/both sides, often tender to touch
• Muscle aches (myalgia)
• Flu-like symptoms
• Fever (≥37.9°C) or hypothermia (<36°C)
• Nausea and/or vomiting

A kidney infection usually happens when bacteria, often a type called E. coli, get into the tube that carries urine out of your body (urethra).

The bacteria travel up to your bladder, causing cystitis, and then up into your kidneys.

E. coli bacteria normally live in your bowel, where they cause no harm.

They can be transferred from your bottom to your genitals during sex or if you're not careful when wiping your bottom after going to the loo.

A kidney infection can sometimes develop without a bladder infection. For example, if you have a problem with your kidney, such as kidney stones, or if you have diabetes or a weakened immune system.

Risk

Kidney infections can happen at any age and are much more common in women.

This is because a woman's urethra is shorter, making it easier for bacteria to reach the kidneys. Younger women are most at risk because they tend to be more sexually active, and having frequent sex increases the chances of getting a kidney infection.

Preventing Kidney Infection

The best way to prevent a kidney infection is to keep your bladder and urethra free from bacteria by:

• drinking plenty of fluids (plain water is best)
• going to the loo as soon as you feel the need to, rather than holding it in
• going to the loo after sex
• wiping from front to back after going to the loo
• washing your genitals every day, and before having sex if possible
• treating any constipation – being constipated can increase your chance of developing a UTI
• not using a diaphragm or condoms coated in spermicide if you're prone to getting UTIs – it's thought spermicide can increase your risk of getting a UTI

If you keep getting urine infections, a GP may prescribe you a low dose of antibiotics to take regularly. This may help to prevent the infection returning or any infection spreading to the kidneys.

• Rest
• Drink adequate amounts of fluid (ideally water) to remain hydrated (adequate means enough to not feel thirsty)
• Take simple analgesia (i.e. Paracetamol up to 4 times per 24 hours) - if you're unsure what you should/should not take, ask your GP/Nurse/Paramedic or a pharmacist
• Gargle salt water
• Suck ice cubes (aids hydration and improves the pain of a sore throat) 
• Distraction is an effective non-pharmacological pain relief
• Avoid smoking / vaping and smokey environments

NHS UK - Kidney Infection

https://www.nhs.uk/conditions/kidney-infection/

NICE - Acute Pyelonephritis

https://cks.nice.org.uk/topics/pyelonephritis-acute/