Editing Urinary Tract Infections (section)

==== Chronic pyelonephritis ====
* '''In patients without underlying renal or urinary tract disease, chronic pyelonephritis secondary to UTI is a rare disease and an even more rare cause of chronic renal failure'''. In patients with underlying functional or structural urinary tract abnormalities, however, chronic renal infection can cause significant renal impairment.
* '''Diagnosis and Evaluation'''
** '''There are no symptoms of chronic pyelonephritis until it produces renal insufficiency, and then the symptoms are similar to those of any other form of chronic renal failure'''
** Similarly, urinary findings and the presence of renal infection correlate poorly. Bacteriuria and pyuria, the hallmarks of UTI, are not predictive of renal infection
** '''Imaging findings:'''
**# '''Asymmetry and irregularity of the kidney outlines'''
**# '''Blunting and dilation of ≥1 calyces'''
**# '''Cortical scars at the corresponding site'''
* Management of radiographic evidence of pyelonephritis should be directed at treating infection if present, preventing future infections, and monitoring and preserving renal function