What is a Urinary Tract Infection (UTI)?

A Urinary Tract Infection (UTI) is a bacterial infection that can occur anywhere in the urinary system, including the ureters, urethra, kidneys, or bladder. However, UTIs commonly affect the urethra and bladder. It happens when bacteria enter the urinary tract through the urethra and can potentially move up to the kidneys if not treated.

Causes of UTIs

The microorganism responsible for UTIs is E. Coli (Escherichia coli) found in the urinary tract. Although it lives in the digestive tract, it can infect the urinary system and cause cystitis (bladder infection) or even kidney infections.

Symptoms of UTIs

UTIs are often diagnosed as bladder infections because the bladder is the most common site affected. Symptoms include:

• Persistent urge to urinate
• Burning sensation during urination
• Frequent urination with small amounts
• Cloudy urine
• Red or bloody urine
• Foul-smelling urine
• Pelvic pain and pain around the pubic area in women

Complications

If treated promptly and properly, lower UTIs rarely cause complications. However, if untreated, UTIs can lead to serious health issues, including:

• Recurrent infections, especially in women
• Permanent kidney damage from untreated kidney infections
• Low birth weight or premature birth if a UTI occurs during pregnancy
• Narrowing of the urethra in men due to repeated infections
• Sepsis, a life-threatening complication if the infection spreads to the kidneys

What is a Kidney Infection?

Pyelonephritis, or a kidney infection, occurs when bacteria move from the bladder to one or both kidneys. It can cause painful symptoms and may lead to the presence of blood or pus in the urine. Existing urinary tract abnormalities can increase susceptibility to kidney infections.

A kidney infection requires immediate medical attention. If not treated properly, it can cause permanent kidney damage or spread to the bloodstream, leading to dangerous infections.

Causes of Kidney Infections

Most kidney infections are caused by bacteria, usually originating from the digestive tract and then spreading to the bladder and kidneys. While bacteria are the main cause, viruses or fungi can also rarely cause kidney infections. Bacteria usually get flushed out with urine, but under certain conditions, they may grow in the urinary tract and spread to the kidneys.

Bacteria from other body infections can also spread through the bloodstream to the kidneys. In rare cases, infected prosthetic joints or heart valves can lead to kidney infections. Post-kidney surgery infections are uncommon.

Symptoms of Kidney Infections

Kidney infection symptoms typically appear 2 days after the infection starts, including:

• Fever
• Chills
• Burning or pain during urination
• Frequent urination
• Persistent strong urge to urinate
• Back, side, or groin pain
• Nausea and vomiting
• Pus or blood in the urine
• Foul-smelling or cloudy urine
• Abdominal pain

Complications

If untreated, kidney infections can lead to serious complications such as:

• Scarring of the kidneys, which can cause chronic kidney disease, high blood pressure, and kidney failure
• Blood poisoning, as the kidneys filter waste from the blood
• Pregnancy complications, such as delivering a baby with low birth weight

Who is at Risk for UTIs and Kidney Infections?

Anyone can get a UTI or kidney infection, but certain risk factors and behaviors can increase the likelihood, including:

• Women, due to shorter urethra
• Hormonal changes, such as during menstruation, pregnancy, or menopause
• Certain contraceptives, like diaphragms and spermicides
• Urinary tract abnormalities, including congenital issues or injuries
• Sexual activity, especially anal sex and having a new sexual partner
• Personal hygiene, especially scented feminine products
• Weakened immune system from conditions like diabetes or HIV
• Enlarged prostate, leading to urine retention
• Dehydration, reducing urine flow
• Long-term use of urinary catheters
• Urinary tract obstructions, like kidney stones or enlarged prostate
• Recent urinary procedures or infections
• Urethral infections from anal bacteria or sexually transmitted infections
• Urinary problems in infants or pregnancy-related changes

Prevention of UTIs and Kidney Infections

To reduce the risk of UTIs and kidney infections:

• Always clean the genital area after bowel movements or urination
• Avoid holding in urine
• Drink plenty of water to maintain regular urination
• Avoid potential irritants like scented feminine products
• Empty the bladder after intercourse
• Wipe from front to back to prevent bacteria spread
• Consider changing contraceptive methods if necessary

If UTI symptoms are severe, consult a doctor to determine the cause and receive appropriate treatment. Each UTI type can present different symptoms depending on which part of the urinary tract is affected.

Kidney Infection Evaluation

Doctors will perform a physical exam, including checking body temperature and blood pressure, and may conduct:

• Urine Tests: To detect infections in the kidneys and urinary tract and identify the bacteria causing the infection.
• Imaging: CT scans and ultrasounds of the urinary tract to assess the severity of the kidney infection.

Author: (Dr. Luthfa Mudrika, MSc, Sp.PK, Chief Medical Officer of Pramita Laboratory Cirebon Branch)