Medical Q&As

Pyelonephritis - renal failure risk?

I had an IVP last October and the result was that I had chronic pyelonephritis. I was also told that my left kidney was badly scarred. I am still waiting to see a kidney specialist but in the meantime I am wondering if I am in danger of developing renal failure?

Pyelonephritis is an infection of the kidney and ureter, which is the collecting system and tube that drains urine from the kidney to the bladder. The letters IVP stand for intravenous pyelogram, which is a special form of kidney x-ray that involves the injection of a small amount of dye into an arm vein that is subsequently excreted through the kidneys. The excretion of the dye is then caught on x-ray thereby delineating the shape, size and state of health of the kidneys and ureters. The scarring of your left kidney that was revealed on the IVP means that the damage has been present for some time and is not of recent origin. The essential function of the kidney is to filter waste material from the blood and if it is not able to perform that function efficiently toxins accumulate in the blood stream. It may be the case that despite the scarring of your left kidney the right kidney may still be able to filter waste material efficiently. The kidney specialist will need to perform a variety of blood and urine tests in order to establish the rate at which your kidneys are filtering. This is referred to as the GFR (glomerular filtration rate), which refers to the rate at which the glomerulus or filtration unit is filtering your blood. There are many of these microscopic units in each kidney. Pyelonephritis can result in damage to the filtration system of the kidneys and is a risk factor for renal failure. However, it needs to be emphasised that renal failure is not inevitable in such a situation. Many people with chronic pyelonephritis do not develop renal failure. Your visit to the specialist will clarify how well your kidneys are functioning and the GFR will assist in determining what needs to be done.