Pyelonephritis is an important clinical type of urinary tract infection. It is pyelonephritis and infectious inflammation of renal parenchyma directly caused by bacteria (very few are fungi, viruses, protozoa, etc.). The disease tends to occur in women, with the ratio of females to a male being about 1:1, especially in married women of childbearing age, female infants, and elderly women. The disease is clinically divided into acute or chronic phases.

The disease is mainly caused by intestinal bacteria, with Escherichia coli accounting for about 60%~80%, followed by para coliform, proteus, staphylococcus, streptococcus, alkali-producing bacilli, Pseudomonas aeruginosa, and occasionally anaerobes, fungi, viruses, and protozoa. Clinically, Pseudomonas aeruginosa and Staphylococcus infections are more common in patients with a history of urinary tract instrument examination or long-term indwelling catheter. Diabetes and low immune function are often accompanied by urinary tract fungal infections. In recent years, pyelonephritis caused by Proteus, Pseudomonas aeruginosa, and Gram-positive cocci has increased.

The virulence of bacteria also plays an important role in the pathogenesis of glomerulonephritis. The human force isolated from the urine of patients with pyelonephritis is stronger, which is manifested as the bacteria contains a large amount of K (envelope) antigen; The ability to attach to urothelial cells (adhesion) is stronger; There are cilia on the surface of the bacteria, which adhere to the corresponding receptors of the urinary tract epithelial cells, and can not flow out of the body with urine; The infection is settled in the urinary tract. In addition, some people regard the adhesion of bacteria as an important factor in its toxicity.

In the infection of pyelonephritis, bacilli are the main pathogenic bacteria, and the bacterial death and endotoxin released during reproduction are also important pathogenic factors. Endotoxin has a variety of biological activities. It can damage the mitochondria of the power plant, reduce ATP production, cause insufficient energy supply of cells, cause cell edema, and accelerate cell autolysis and death. In addition, endotoxin can also damage the lysosome membrane, affect the function of microsomes, and destroy the process of cell utilization of oxygen. Therefore, endotoxin is a factor that cannot be ignored and ignored by clinicians in the pathogenesis of pyelonephritis. In recent years, research on this aspect is increasing. Some scholars reported that the Limulus test has significant specificity in judging the infection of gram-negative bacteria in the urine. For example, the positive rate of the Limulus test is 87% in urine samples with a number of bacteria in urine culture greater than 105/ml, and 99% in urine samples with a number of gram-negative bacteria greater than 105/ml. In the past, pyelonephritis has always advocated the use of antibiotics in combination with other treatments, ignoring the treatment of anti-endotoxin. In addition, pyelonephritis has a long therapeutic effect, and patients often can not adhere to it. It is easy to make the disease not be thoroughly treated, and become chronic, thus damaging renal function.