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Differences between pyelonephritis and UTI

Pyelonephritis vs UTI

UTI or urinary tract infections are one of the common infections affecting human beings. Since the urinary system is in constant proximity to metabolic waste from the body, it is more prone to infections than other systems of the body.

UTIs can be classified as upper and lower based on the site of infection. Infections of the kidney and ureter are called as upper UTI while those of the urinary bladder, prostate and urethra are termed as lower UTI. Colloquially speaking, when not specified, a UTI means a lower UTI, more specifically a bladder infection (cystitis). Pyelonephritis is an infection of the renal pelvis, the region of the kidneys from where the urine drains into the ureters and is carried away to the urinary bladder. It is relatively rarer than UTI as it higher up and chances of the body’s immune system eradicating the infection by then are high.

Children and elderly are more prone to UTIs. In adults, women are more prone to UTIs than men; especially during pregnancy, sexual intercourse and menopause. Use of spermicides also increases the risk of UTI.  At least 50% of women have suffered from a UTI at some point in their lives. In men, UTIs are rarer and when present, commonly complicated with another underlying condition like an enlarged prostate etc. Catheterisation is a frequent cause for developing a UTI.

E. Coli is the commonest causative agent of any urinary system infection. Symptoms of an uncomplicated UTI are burning sensation while urination, increased frequency of urination, poor control over urge, pinkish or whitish urine, pain while passing urine and fever. Occasionally, there might be lower abdominal pain. Pyelonephritis being a more serious infection, presents with high-grade fever, shivering/chills/rigors, vomiting, pain in the back and sides of abdomen and in advanced cases, with a reduced urinary output. Pyelonephritis might even present with simple nausea, vomiting and high fever with no urinary symptoms and a high index of suspicion is required on the part of the physician to diagnose it.

Diagnosis of a UTI is usually made by a urine dipstick test, microscopic analysis or urine culture while pyelonephritis routinely requires a full blood count along with urine tests. Occasionally, an ultrasound of the abdomen and pelvis might be needed to rule out an underlying stone or growth predisposing to recurrent UTIs.

Treatment is by antibiotics. Uncomplicated UTIs usually recover rapidly within a week with adequate antibiotics and water intake. Complicated pyelonephritis might need hospitalisation for 1-2 weeks to administer antibiotics intravenously. The weakness is greater and recovery takes longer too. Consuming cranberries is thought to be beneficial in a UTI along with plenty of water.

Take Home Points:

UTI is an infection of the urinary bladder i.e. cystitis. Pyelonephritis is an infection of the kidneys.
Both are common in women than men esp. during pregnancy, sexual activity and post-menopause.
In men, they are often associated with an enlarged prostate or prostate cancer.
Symptoms of UTI are burning or pain while micturating, fever, increased frequency and urge of urination. Symptoms of pyelonephritis are more vague, often unrelated to the urine and manifest as nausea, vomiting, high grade fever and shivering.
Both are completely treatable with antibiotics and recovery takes place within 1-2 weeks.


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