From the Guidelines
Dehydration can increase the risk of developing pyelonephritis, but it is not a direct cause of kidney infection. According to the European Association of Urology guidelines on urological infections, published in 2024 1, pyelonephritis typically presents with fever, chills, flank pain, nausea, vomiting, or tenderness at the costovertebral angle, with or without symptoms of cystitis.
To reduce the risk of developing pyelonephritis, it is essential to:
- Stay well-hydrated by drinking plenty of water, as dehydration can concentrate urine, allowing bacteria to multiply more easily in the urinary tract 1
- Urinate frequently and completely, especially after sexual activity
- Practice good hygiene, wiping front to back after using the bathroom
If pyelonephritis is suspected, seek medical attention immediately, as prompt treatment is crucial to prevent complications. Treatment typically involves:
- Antibiotics, such as fluoroquinolones or cephalosporins, which are the only recommended antimicrobial agents for oral empiric treatment of uncomplicated pyelonephritis 1
- Pain relief, such as over-the-counter medications like ibuprofen
- Increased fluid intake to help flush out bacteria
It is essential to note that dehydration can increase the risk of infection spreading to the kidneys by concentrating urine and allowing bacteria to multiply more easily in the urinary tract. Proper hydration helps maintain regular urine flow, which naturally flushes out bacteria and reduces infection risk. Therefore, staying well-hydrated is crucial in preventing pyelonephritis, especially in individuals with underlying urological abnormalities or comorbidities 1.
From the Research
Dehydration and Pyelonephritis
- Dehydration can be a contributing factor to the development of kidney infections, including pyelonephritis, as it can lead to a decrease in blood flow to the kidneys and increase the concentration of bacteria in the urine 2.
- However, the relationship between dehydration and pyelonephritis is not fully understood and may be influenced by various factors, such as the severity of dehydration and the presence of underlying medical conditions.
Risk Factors for Kidney Infection
- Clinical dehydration has been identified as a risk factor for analytical alterations, including acute kidney injury, in patients with febrile urinary tract infections 3.
- Other risk factors for kidney infection include high fever, use of certain medications, and underlying medical conditions, such as diabetes or kidney disease.
Prevention and Management
- Rehydrating with electrolyte solutions may help prevent kidney injury in individuals who are dehydrated or at risk of dehydration 2.
- Avoiding excessive sodium-free fluids and consuming fluids that contain sodium and carbohydrates may also help prevent dehydration and kidney injury during exercise or in hot weather 4, 2.